The relative roles of the individual and the collective in framing and developing welfare services has been an ongoing theme in much of social policy development from at least the nineteenth century. The rise of welfare states in twentieth-century Britain and much of Europe testifies to the predominance of the collective view; that is, a concern with public protection and welfare as a shared public good, involving conceptions of the citizen as ‘client’ who is served by a professional bureaucracy. More recently, this idea, fundamental to the way welfare states were conceived, has been eclipsed by the idea of the individual with rights and entitlements to services. This individualisation of welfare points in a distinctly different direction: towards cash entitlements, ‘person-centred’ care, citizens’ claims on the state and the centrality of the user of services rather than the power and discretion of the professional.

This book casts some doubt on the usefulness of this simple dichotomy, arguing that individualisation, as recently understood, has taken but one form in terms of its stress on the individual as the unit of social action. The author argues that individualisation may be conceived as taking two alternative routes on the way to the aim of promoting welfare. The first, the individual as a will, involves the individual acting to secure their wishes by asserting their preferences as a consumer – the theme of much recent policy and writing on individualisation. The second, the individual as a self, involves a richer conception of the individual as embedded in a service delivery relationship, where their rights and opinions are upheld but where the need for professional intervention and protection is recognised.

This distinction has much in common with Berlin's (Reference Berlin1969) idea of negative and positive liberty (freedom from interference by professionals, for example, versus freedom to pursue an individual's own sense of self). The individual as will, for example, often posits the welfare professional as controlling and unsupportive of the user's wishes. To achieve real freedom, that conception therefore eschews professional structures (for example, professional assessments) instead leaving the individual to state their wishes through ‘consumer directed’ models (such as direct payments). The problem with this, for the author, is that such a conception treats the user as a thing, it discounts the service delivery relationship (which is important where issues such as public protection and the care of involuntary clients are concerned), and it can privatise risk, by casting aside the wider responsibilities of public welfare workers and users themselves. Drawing on psychoanalysis, particularly the object relations school and the work of Donald Winnicott, the author argues for recognition of welfare services to be delivered, instead, according to principles that assert the subjective right of individuals; this can only be done within a public relationship that respects the need for a higher authority for the purposes of public accountability.

However, whatever theoretical underpinnings might be used to advance the argument, the ideas are framed in an engaging and conversational way, a very difficult feat to pull off when discussing this sort of material. There are many examples from the author's own work and experience, as well as those from a series of Australian case studies where the idea of the individual as a self is sketched out. The chapter with Michael Fine, for example, reviews the development of Community Aged Care packages in Australia with the idea of individualised approaches to planning and delivery being present since their inception. Individualisation, in this conception, is directed at the service delivery relationship and acknowledges the complexity and multiple needs of older persons who require such care. The idea also recognises the limits of involvement of some, such as those with dementia, and attempts to tailor services as far as possible to the individual whilst also upholding public accountability of service providers and funding. The approach is thus not primarily directed at the ‘wishes’ of service consumers, but recognises the complex interplay between the rights of service users and the obligations of professional staff, the need for individually tailored assessment (to ensure a full range of needs are uncovered and met) and the development of creative responses to need (recognising that this is only possible with a degree of oversight and monitoring). This approach has obvious analogies to original proposals for the post-1993 system of community care in England (not all implemented as intended by local authorities it must be said), albeit that the Australian system has developed a more detailed and integrated assessment system (through their Aged Care Assessment Teams). This engaging chapter shows the necessity of explicit principles to set the conditions for individually tailored care rather than by assuming the only way this can be achieved is through marketised structures of wish fulfilment. In all, the case studies show that it is possible to achieve individualised approaches within a public bureaucracy and that professionals as well as service users have roles to play.

The book discusses issues around the individualisation of welfare services from a distinct perspective. It is what could be termed a thesis or sketch of the theory underlying individualisation, rather than a comprehensive review. So, there are inevitably omissions; there is no Kant, for example, or Bradley or Richter in outlining the ethical basis for individualisation. However, the book is well organised and marshals its argument well, although I would have liked a concluding chapter drawing together the themes arising from the case studies, which referred back to the initial theoretical arguments in the earlier chapters.

These are minor reservations however. The book is a welcome antidote to much current rhetoric on so-called individual or ‘personalised’ approaches to welfare. Overall, this book shows the limits of policy exhortation from the centre, in that policymakers merely advocating ‘person-centred care’ and individualised approaches may change little on the ground, the place where the service delivery relationship actually functions. Moreover, wholesale service redesign around the will of the individual, as has happened in some countries, will inevitably turn up tensions and contradictions that, unless heeded, may result in unsustainable practices, particularly in these more straightened economic times.