Plans to allow patients to hold personal budgets, that can be used to buy the NHS services they want, have been heavily criticised by the BMA.
In response to the government’s consultation on personal health budgets, the BMA said they will create a new layer of bureaucracy for PCTs and divert funds into unproven treatments.
Personal budgets have been widely introduced into social care in recent years and the government is keen to extend them into health.
They’re intended to create a more personalised NHS by giving people more control over their care. They involve giving money to individuals to allow them to buy their own health care in line with an agreed care plan. Patients who are intended to benefit include those with long-term conditions.
In social care, personal budgets have proved popular among service users with physical or learning disabilities, but have not been embraced by older people.
The BMA is also concerned that giving some patients the ability to make direct payments for their care could undermine equality, even though the money is from the tax payer. The system could come to favour those that hold budgets over those that don’t.
Other concerns include personal budget holders being exploited by third parties; how to ration care if patients spend their whole budgets; ‘banking’ of funds against a rainy day rather than spending what they need on care now; and, further reinforcement of healthcare as a commodity.
Dr Hamish Meldrum, chairman of council at the BMA, said: “We believe in choice and flexibility for patients but these plans are worrying for a range of reasons. Apart from the practical difficulties and added bureaucracy involved, direct payments would take us even further towards a model where healthcare is a commodity to be bought and sold rather than something to which people are entitled.
“These proposals potentially undermine the principle of equal access on which the NHS is based.”
PCTs are currently involved in 70 pilots that have been running since October 2009. The government wants to evaluate the pilots and introduce a refined personal budget model from summer 2010.
Stephen Campion, chief executive of the HCSA, said: “In the current economic climate there should be a moratorium on initiatives such as this. The reality is that the NHS is struggling just to stand still. Do patients really want to be further worried about managing their finances and purchasing options in addition to having their health and social care needs met? I am not so sure.”
Tags: Personal budgets
Whenever you see proposals like this you have to ask “who benefits?” and “where is the evidence for using it?”.
The obvoius beneficiaries are private health care providers who want to muscle in on the NHS. I’ve yet to see any evidence of benefit to the average patient.
Also, as Mike says, if the patient spends all their money inadvisedly, who’s going to pick up the pieces - think I might be able to guess the answer to that one.