Paying the Piper and Calling the Tune: Power and the Direct Payment Relationship

Abstract

This paper provides empirical evidence from original research, which investigated the impact on the support relationship of the direct employment of workers, by direct payment users. The study used a grounded theory approach, with questionnaires to measure job satisfaction and stress, and in-depth interviews with respondents. It explored and compared the experiences of eight direct payment relationships with eight traditional service delivery homecare relationships. The research reveals the importance of the concept of power in helping us to understand the effect of direct employment and, based on this research, makes some suggestions for policy and practice.