Direct Payments are cash payments made in lieu of social service provisions, to individuals who have been assessed as needing services. The implementation of direct payments in the United Kingdom in 1997 represented a major victory for the disability movement in securing enhanced choice and control in service provision. Successive governments have promoted direct payments as part of wider strategies to develop local care markets and enable a 'personalisation of care'. Since 1997 a number of changes have emerged to the original policy framework, allowing wider access and a more diverse user population. Whilst these changes have occurred across the UK, different take-up patterns have emerged in the various UK countries where administration of social services has been devolved. In exploring these patterns, this study focuses on the impact of direct payments in Scotland. Drawing on findings from a major UK wide two-year study of direct payments, the authors highlight some of the key tensions which have characterised policy implementation in Scotland, alongside a comparative overview with the rest of the UK. The approach adopted in the UK has features that are of interest to those contemplating effective methods for care provision in other states. In common with other titles in this series the book presents a variety of perspectives and approaches with which to consider the key issues. It is written at a level that will stimulate those wrestling with these themes from a professional perspective as well as providing essential reading for those studying health and social policy.