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Call to hand budgets to patients

By Christian Duffin

Radical proposals to hand patients their own ‘personalised budgets' to spend as they please on treatment have been given a guarded welcome by GPs.

The recommendations come in a report from the influential Health Services Management Centre, based at the University of Birmingham, which claims patients would be empowered and save the NHS money if they were put in charge of the purse strings.

Its proposals would see the introduction of a direct payments system, similar to that already used in social care, with the report calling for pilots in six areas including care for people with long-term illnesses, mental health services and maternity services.

Lead author Dr Jon Glasby, professor of health and social care at the centre, said: ‘It is not about privatising health services. It is about citizenship and the right to be in control of your life. Research shows the system works well in social care.'

The National Association of Primary Care (NAPC) backed the idea in principle, for patients with long-term conditions, although it argued that setting budgets for most patients would be very complicated.

It also warned that it would be virtually impossible to calculate budgets for a large number of patients with complex conditions and unpredictable needs.

Dr Kingsland, NAPC chair and a GP in Wallasey, Merseyside, said: ‘It could arguably be good for patients to give them a certain number of NHS credits, so they could see their budget going down. It may mean next time they phone an ambulance they think about whether they really need it.

‘But we already have difficulties getting accurate information for budgets. Personal budgets would be a bridge too far.'

The NHS Confederation has already championed personalised budgets, although deputy policy director Jo Webber said patients could not be merely handed money without legislative changes. GPs could give advice and monitor the spending through indicative budgets, she added.

Dr David Jenner, NHS Alliance lead for GMS/PMS, said the idea had potential. ‘It may work for patients with clearly defined conditions where perhaps they only have to choose between two providers.'

But he said most patients did not want choice or control over their budgets – just good local services.

Dr Glasby argued his idea could ‘help remove some of the current funding inequalities in the NHS'.

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