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Government announces roll out of 'patient budgets'

Tens of thousands of patients will be able to get cash from their doctors for “personal health budgets” which can be used for activities including singing lessons and other hobbies, it has been announced.

Patients will have access to the budgets which give them more choice and control over the care they receive, according to care and support minister Norman Lamb.

Ministers have decided to roll the scheme out after a successful pilot.

During this, one patient who suffered from depression used the budget to pay for a therapist and to begin a dress-making hobby. Another who suffered from chronic lung disease used the money for singing lessons.

A male patient with motor neurone disease used his personal budget for a modified bicycle and a gym membership. Other patients used the scheme to employ carers to look after them at home.

The budgets will allow patients to have more control over the treatment they receive instead of simply getting care set out by the NHS.

Patients will be able to access the budgets through their local NHS.

They will have to work with clinicians to decide how the money would best be spent to benefit their health.

Ministers are investing £1.5m in the hope that by 2014, it will be available to 56,000 people on the NHS Continuing Healthcare scheme - an initiative for patients who suffer from complex medical conditions who require a lot of care and support.

“Independent analysis has now shown that personal health budgets can put people back in control of their care and make a significant difference to their quality of life,” Mr Lamb said.

“It’s inspiring to hear the human stories of success that these budgets have brought to people.

“The evaluation shows that those with the greatest needs benefit most from personal health budgets.

“That’s why we are giving people on NHS Continuing Healthcare the chance to get one first.

“And, I hope more people who could benefit will be given the option of one.”

Charity In Control pioneered the concept of personal budgets in social care.

Julie Stansfield, chief executive officer of In Control said: “We are extremely pleased, as we know many families will be, to see such strong evidence that enabling people to self-direct their health support via personal health budgets is making a positive difference.”

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Readers' comments (19)

  • I can't believe how this is filling me with horror. In the USA their politicians are also playing with this idea of personal health budgets. So instead of buying dress making hobbies or gym membership, on a diagnosis of say, cancer, patients will be given their personal health budget to spend as they wish.
    Chemotherapy, Sir?
    Or a spot of radiotherapy?
    You say you have spent your budget on surgery? No worries, you can choose to buy your chemo at a very reasonable rate. Ah, can't afford it. Not to worry.
    It's a way of reducing the cost (to the state, not the taxpayer) and excluding sections of the population from healthcare.

    This is the thin end of the wedge. It will be seen as a pilot, hailed a succes and rolled out to all healthcare if we allow it. Again, a real potential to harm the vulnerable in society.

    "No top-down reorganisation of the NHS"
    "The NHS is safe with the Tories"

    And a man in charge who believes that the NHS should not exist.

    You could not make it up.

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  • tinkerbell

    Anonymous | 30-Nov-2012 9:00 pm
    Initially when i first read this article i wasn't sure what to make of it, initially it sounds good but still can't actually work out what it all means. Is this a budget that you are given and then when you've spent it, on whatever, you've had your lot as far as your treatment is concerned so have to buy any further treatment yourself? Surely not.

    I don't get it.

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  • Tink,
    The Tories are gauging public response with this idea. Remember, the Tories believe that the state should not interfere in the lives of private individuals and this point of view is driving their break-up of the NHS.

    My belief is that if this programme is successful then individuals will be given more and more control of their health budget...and then a cieling to that budget will be introduced. Great if you never get ill (make as many dresses as you like) but what if you have multiple illnesses? Do you spend your budget on your expensive cancer treatment, or diabetes, or MND? Or die happy whilst making another dress?

    Everything that is good about the NHS is despised by the Tories, they are out to destroy it, piece by piece. And make a fast buck for their mates in big business. Of course!

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  • I can't see this ever happening( not that i think its a good idea in the first place, just another loony idea from the home of ridiculous ideas).

    I can see rationing looming, those who shout the loudest /those who make themselves a real nuisance scooping the jackpot and gate keeping being the devil in the detail...

    I tried to get my GP refer me to the NHS funded but local authority run, Weight Loss programme. She was SO reluctant to do it, it took me 30 minutes, in a 10 min slot to get the much needed deed done. What are my chances of getting something out of her budget for our health care? I think a snowballs hope in hell.

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  • tinkerbell

    Anonymous | 30-Nov-2012 10:29 pm

    'Everything that is good about the NHS is despised by the Tories, they are out to destroy it, piece by piece. And make a fast buck for their mates in big business. Of course!'

    We are in total agreement there. If it is their intention to mislead people even further with this 'scam', then their deviousness exceeds even my imagination of what a bunch of shisters they truly are.If this is the case then they have excelled themselves at 'how low can will they go?'

    Sing yourself well.

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  • tinkerbell

    A GP practice run by a doctor who has been of one of the most prominent supporters of Andrew Lansley's health reforms de-registered elderly and disabled care home patients to save money, an NHS investigation has found - Guardian.

    Just had a read up on it. Rogues and Scoundrels!

    This is what we are to become. Scary stuff.

    What if one patients needs are greater than mine, will they be able to spend my allocated budget, so that when i go to my GP for e.g., some antibiotics for whatever they say 'sorry, we've had to spend your budget on some more unwellperson so get stuffed and find another GP who's caseload isn't so financially draining where the majority of well people go'.

    We all end up in a bun fight over someone who's more unfortunate.

    Couldn't make it up could you? Unf******believable.

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  • tinkerbell

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  • We don't have enough beds for patients, we don't have enough staff to look after patients, we have hospitals going into administration, we ration life-saving treatments and surgery, we have the elderly dying at home because they can't afford to put the heating on, we have thousands of children and youngster put into care, we have thousands of homeless people wandering the streets yet suddenly we can afford these 'extras'.

    Sorry but can't people pay for these things themselves or ask their families to pay. Perhaps someone with MND could have been given free gym membership in the first place. How about joining the local adult education centre?

    Where exactly is this money coming from? taxpayers I suppose.

    Who checks on how the money will be spent, can you just spend it on what you like?

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  • michael stone

    I heard ('one ear' concentration level) 'a trial of this' being discussed on Radio 4 this morning, by both the mother of a son with complicated healthcare needs, and also a doctor.

    I am worried, that it will be perverted to a simple 'how can we save money' thing, by politicians.

    But in this mother's case, without the 'personal budget' of about £23,000 per year (figure from my memory, which she spent on carers, basically - apparently her son had started to object to her caring for him) she said her son would have had to be institutionalised, at a cost of about £3,000 per week.

    And it seems it isn't 'a fixed amount of money per patient' or 'give the money to the patient and leave them to it' - it is more 'the patient and doctor get their heads together about the spending'.

    However, I also have doubts - the NHS isn't usually spending thousands of pounds per week on patients, and my gut feeling is that the less money being spent per patient, the less well this idea works.

    It also seems to link in to the 'expert patient' concept, to an extent.

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  • tinkerbell

    I'm really not sure about this one so i'm going to stand down on any further comment until i get a better understanding of what the heck it all means, if this is ever possible with this money grabbing government, because although it sounds good for those with continuing care needs and could improe their quality of life and be person centred/individualised and i am all for patient power, i can't help but think 'there must be a catch'. We've all been taken to the cleaners so far with what was OUR NHS so why should this by any different.

    It could take me a few years to work this one out. Bye for now.

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  • there's always a catch, if it sounds too good to be true then it usually is. this money will be allocated from another, already existing, budget somewhere so don't be fooled.

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  • Personal health budget, sounds great, always good when patients have more ownership over their care. But how many pilots having so much money pumped into them covering such a relatively small number of patients. Thought they wanted to save money, where did this pot come from. I reckon the 'pilot' will be a success. So why not implement a wider community health/social care support programme with existing schemes out there.
    Would each patient have an 'account', like a deposit bank account or a credit account. One you pay in for future use on rainy days/years, the other you use then pay back later or raided from someone else's account. Then, as I prefer prevention is best, can I use my account money for a better lifestyle, gym membership, socializing with family + friends, basically get a life by reducing stress I get when trying to improve other people's lives at work.
    If some patients need a few hundred or thousand pounds per week, can I have some of my share now in my salary so I can choose my health improvement plan + rest later to fix anything that unexpectedly pop up ;)
    There's going to be a cap some where + raiding of other people's accounts who are normally fit + well. Rich people might suggest, how about not contributing into NI, so they would pay for use/access to services when they need it and easy for them to put money aside for that. Isn't that what happened pre-NHS.

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  • or maybe that is Rich people might suggest their 'altruistic NI contributions gives them access to private beds, enhanced fiesta-class care on the NHS for free lol, while the rest of us plebs are in standard class care. Noting than some plebs are better than others (was that 4 legs good, 2 legs better)

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  • michael stone

    Andy and Tink - I have the same suspicions as you: this looks good, the trial will have been different from te way it gets rolled out, and it will probably be subverted away from 'better care' towards 'spending less'.

    Also, I have this horrible feeling that things often go pear-shaped when they go from small scale trials to a general roll-out, because the people in the trials are committed and expert, and also use their sense, whereas the roll-out has always got some sort of 'tick-box behaviour' attached to it, or else rapidly develops some tick box rules.

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  • As a patient, how on Galifrey would I know what to spend the money on?

    I have no idea what I would spend the money on. I would ask nurses advice's first as I trust you all

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  • tinkerbell

    it is very important that there is a rating system for your hospital stay when 49% of hospital beds become privatised, because there will be first class, second class and economy probably. Do you want an upgrade

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  • Is everyone entitled to this? If not, where are the boundaries set? What checks are in place to ensure money is spent on the healthcare requested? Do patients actually get their hands on the money, or is it spent on their behalf? What's to stop money requested for , say, gym and alternative therapies being spent on fags, booze and drugs? Can a healthy person request a budget to spend on healthy food options to ward off illness?

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  • tinkerbell

    Cameron's "sham" listening exercise
    Website Social Investigations reveals how private health firms were working with Downing Street during the "pause" to ensure new legislation went ahead, even though there was supposed to be a "listening exercise". There was no "pause" as the government claimed at the time nor a temporary halt to its efforts to introduce more competition within the NHS through its controversial health and social care bill.

    "Cracks are beginning to appear in the NHS" - Kings Fund
    A Kings Fund report reveals that there "..are huge risks, particularly in ensuring that quality of care does not suffer with the further financial squeeze. The stakes for patients could not be higher".

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  • lets just give all the funding to patients to spend how they see fit!

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