Direct payments and personal budgets are crucial components of the government's personalisation agenda in health and social care. They work on the simple principle that if individual citizens have control over the resources necessary to meet their needs, they are likely to take better decisions about how these resources are used than agencies attempting to do so on their behalf. When the minister for social care services stated recently that "now's the time to step on the gas when it comes to personalisation", it was a concession that change needs to go further and faster. In 2006 only £2 out of every £100 spent on social care went in direct payments, though the enabling legislation was passed a decade earlier. Why has the pace of change been so slow? Are there flaws in the principle itself, or have cultural, institutional or technological barriers combined to slow its implementation? And if public services embrace the principle, how far will it carry them in practice? The case for reform must start with its proven benefits for vulnerable citizens. Evidence consistently shows that those in receipt of direct payments or supported through individual budgets are usually more satisfied with their outcomes than those who receive direct services. When made available with the appropriate support, these arrangements significantly enhance the ability of citizens to shape their lives in line with their own needs and wishes. Some areas have enjoyed significant savings, as direct payments offer excellent economies of penetration – delivering value straight to the citizen. Effective payment technologies can reduce back- office costs dramatically. But arrangements that are inherently more satisfactory for citizens may com-plicate demand management by encouraging larger numbers to seek support. Their purchasing decisions will then be unpredictable, placing new demands on local infrastructure. Ironically, selling the case for financial innovation can be especially difficult in straitened times, even when potential benefits are considerable. Financial nervousness is only one barrier. Another is the reluctance of some social care professionals to relinquish control, particularly when they retain responsibility for outcomes. Public authorities as well as professionals have become highly risk averse. Is there reputational risk, or even legal risk, to professionals and local authorities if individuals receiving direct payments choose, for example, to use some of their money on pub lunches rather than the council's meals service? National government has a critical role in establishing a more risk-tolerant environment. Anxiety about complex and unpredictable payments can now be allayed by increasingly sophisticated IT solutions. They have the proven capacity to deliver cost savings and clarify audit trails. Lewisham predicts that its pre-paid cards to support young people leaving care will reduce processing costs by over 60 per cent. Payment technology can also allow providers to retain a measure of control, from direct restrictions or guidance on what to spend, to effective monitoring post-purchase. The reluctance of some professionals to embrace direct payments is now outweighed by cultural change in society at large, where citizens are more IT confident, and expect more information, more say and more accountability. Will these trends carry direct payments and personalised budgets into other forms of service provision? Certainly, the councils and agencies that have embraced personalisation most creatively have found new applications for the online platforms that support direct payments. Strong IT systems support improved citizen information and easier service access, both of which are fundamental to personalisation. Services are re-thinking not only how they relate to citizens, but how they relate to each other. Yet however welcome the move towards personalisation, it throws up significant issues about individual capability and the relationship between individuals, communities and the state. At least two questions need to be asked on a case-by-case basis before direct payments can be considered a desirable option. First, does the service confer a predominantly private or a predominantly public benefit? The public will have a greater legitimate interest in how ex-offenders manage their support package, than in how carers manage their respite care. Secondly, in what circumstances do citizens have the capability to control their own budgets? Disability rights groups have challenged a smothering tradition of paternalism, but is it reasonable to make the default assumption that others in need of social care support are "expert users"? Direct payments and personalised budgets are at the forefront of critical conceptual and logistical changes in public services. Though there is disagreement about where they will lead, few can doubt that they are iconic for the future of public services. To view the article at it's source please copy and paste the following link into your browser - http://bit.ly/cERMiQ