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Patients to be given 'fundamental right' to personal health budgets

Patients will be given even greater rights to receive a personal health budget from October next year, after a Government minister claimed that the current plans do not go far enough to support patients.

Under the new plans, announced this week by care minister Norman Lamb, patients with long-term conditions will be given the right to receive a personal health budget - as opposed to simply requesting one, as the original plan stated - from October next year.

Speaking at a Commons health committee meeting on Tuesday, Mr Lamb said the Government’s original plans did not go far enough to ensure CCGs offer the option of personal health budgets to people with long-term conditions.

The budgets – a lump sum for patients to spend as they choose on their healthcare needs – were originally enshrined in the government’s NHS mandate as something a patient would ‘have the right to ask’ for.

But Mr Lamb said to ensure there would be ‘change across the system’ he wanted it to be a ‘fundamental right’ to hold the budget, adding that he wants to see the scheme extended to people with mental health problems.

He said: ‘When I came to post last September there was a plan to legislate for a right to request a personal health budgets for people on NHS [continuing healthcare].’

‘I felt that doesn’t do enough to change behaviour across the system. There will be some CCGs that are very good at encouraging and facilitating people in taking control, but others that will do very little to change the traditional way of doing things.

‘I wanted a “right to have” a personal health budget not just a right to request [one], which will come in force in October next year. So from April next year, there will be a legal right to request, but ultimately for the CCG to say no. But from October it will be a right “to have”.’

Mr Lamb added that the right to hold a personal budget would be ‘subject to some safeguards in cases where it proves impossible, but it will be fundamentally a right to have a personal health budget’.

And he said: ‘I’m very keen that we extend that beyond people that have NHS continuing care – a prime area [in which] I would like to develop the concept is mental health.

‘If there is any area where we should be empowering people to take more control of their lives then surely it is mental health.’

The announcement came as the Department of Health said patients ‘who could benefit’ will get the option of holding their own personal health budget, ‘subject to the evaluation of the pilot programme’, in an updated draft of the NHS Mandate.

Mr Lamb said the pilots showed that ‘in areas where power was given to the patients, the best results emerged’.

Quizzed on the use of complementary and alternative therapies, including piano therapy, tai chi and sports therapy under the use of personal health budgets, Mr Lamb said patients had shown they were ‘good custodians’ and should not be constrained in using the budgets as they choose – although he conceded that ‘markets would develop’ in complementary and alternative therapies as a result.

He said: ‘We’ve got to open our minds. Let’s focus on what is the central principle in the Care Bill, which is wellbeing – we shouldn’t be asking what service can we deliver, we should be asking how do we help this person to live a good life?’

He added: ‘If you have personal health budgets for particular areas of care, I suspect that markets will develop for the sort of things people want to use the money on – but where it’s rational for the individual, we shouldn’t seek to overly constrain the way the money is used.’

‘People tend to be pretty good custodians of the money as well. They don’t choose to go out and spend it rashly, they realise it’s a scarce resource.’

Readers' comments (26)

  • 'People tend to be pretty good custodians of the money as well. They don’t choose to go out and spend it rashly, they realise it’s a scarce resource.’

    Mr lamb, please wake up and smell the coffee. The country is not made up of well educated upper middle class like you. I work in the deprived area (which, by the way is associated with higher health problems), and many of my patients can't manage to budget for their food, let alone health benefits.

    I'll give you some examples. My colleagues here will sadly agree these are not unique.
    Patients can't afford a bus/taxi fare to come to surgery and demand a home visit. Yet when I arrive they are puffing away on cigarettes and own a bigger tv then I've ever owned.
    Alcoholics asking for nutritional feed as he's spent all his money on booze and can't afford food.
    Patient feeling depressed as she is in huge debt, yet wearing designer clothes and going on holidays.
    I know a relative who hasn't worked for 30+ years yet he's managed to pay off mortgage, had several cars, mobility scooter, regular dine outs, even paying for daughter's debts. all courtesy of the benefit system.

    Get the picture? Why are you blowing the money away when the very health care is being stretched and we are fee d to make efficiency savings (aka budget cuts)? Oh I know why, nothing like giving money away to make you popular yeah?

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  • If people spend their budget unwisely, who picks up the tab when they are in desperate need?

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  • Anon 9:02

    no one. Personal health budgets doesn't refer to the amount of treatment a patient can spend in NHS. It's a bonus lump sum to spend on what ever they wish. I remember pulse did an article on what patients in pilot spent - laptop, holiday etc

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  • God give me strength

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  • Ah, wonderful. a return to my favourite story.

    Brilliant news - a 'right to have' rather than 'just ask'. A lot of patients (particularly those damaged by controlling power-hungry, Kafkaeseque therapists and GPs) will finally get some control over the design of their care.

    Personally, I'm not planning to asking for a laptop - but if I do, hope it doesn't have a virus or I'll be back to see you again. Or perhaps I could request a Tablet?

    Let's face it - GPs real opposition to personal health budgets is that it challenges their/CMHT power as omnipotent gatekeepers to the health service. This is a victory of patients rights and autonomy. I just wish we didn't have to wait a year for it.

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  • A bureaucratic nightmare!

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  • "A right to have" just about sums it up.....

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  • Mr Lamb "wants to see the scheme extended to people with mental health problems". The lunatics can really take over the asylum!

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  • Just out of interest, what treatments and therapies will no longer be funded directly by NHS and will only be available from personal health budgets to free up the money needed?

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  • @SteveMartin

    Why the discriminatory attitude toward people with mental health problems? I'm disgusted by the attitudes of so-called "professionals" posting on Pulse.

    Time for revalidation?

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  • annonymous at 1.02pm - please push off from this website if you are unable to take a comment in the way intended and you are not a health professional.

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  • So anyone who stands up against mental health discrimination should "push off" should they?

    Interesting "professional" values you've got there.

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  • It is not discriminating against patients with mental health issues to suggest that they might not be capable of looking after a personal health budget. Many such patients of mine struggle to answer the phone and open their post. It is a fact that perhaps patients without insight etc are not best placed to manage their own health budget. The lunatics taking over the asylum comment was obviously meant in jeat which, had you been a health professional, you would have realised. Why get annoyed when asked to not post on a site specifically for health professionals? I would not dream of posting on any site for which I did not qualify.

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  • @1:58
    My professional background is mental health. And your point is?

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  • We are going off topic here.

    Point which all of us are trying to mak is, politicians are trying to give autonomy without incurring any form of responsibility. This means patients can spend their 'budget' and still has rights to access the usual nhs services. Money they spend will not affect their usual treatments out the duty of the nhs to provide care as set out in the patients charter.

    When we have limited resources, how can this be justified?

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  • It all becomes clear. Your own lack of insight is astounding and worrying. Work for a Crisis Team???

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  • Anon 1.58pm

    "I would not dream of posting on a site I did not qualify" Really? I find doctors & mental health 'professionals' sticking their nose into all sorts of places where they are not wanted.

    If you want this forum restricted to 'health professionals only" - and it is awfully small print - I suspect market economics mean it will have to become paid-for.

    I can see how some mental health patients might need support to manage a personal budget - sadly they are also the ones most of risk of mistreatment from the health service. A personal budget will give them choice and dignity.

    It cannot come soon enough - but like it or not, it is coming.

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  • Guys, if you want to debate of topic subject, please do it else where.

    Anon 2:48

    Have you considered the cuts nhs is having to makesure to financial constraints? I know a psychiatry consultant who is constantly under pressure to discharge patients, see targeted number of patients in clinic (hence spending less time with each patient) etc. Instead of funding such service adequately, money is being spent on politically favored services such as nhs 111, personal health budget.

    Next time when your client cannot access GP, psychiatrist, crisis team, social care etc, would you be telling them services are cut and the money was used for personal health budget?

    Like it or not it's coming. Please don't moan when you realize other nhs services are cut to fund your fantastic personal health budget.

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  • I, and I suspect other GPs like me, have no choice where to refer a patient for mental health services. The location of my practice limits my referrals to one organisation. I cannot see how mental health patients having a personal budget will enable them to have choice.

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  • Anon 3.53pm
    I think the idea of a personal budget is that you can opt for therapies not provided for (or in some cases access is obfuscated to) in your locality - e.g arts therapies. My experience of CMHT psychotherapist is such that I would not accept a referral anywhere - even if the GP was empowered to refer out of locality.

    Anon 3.45
    Maybe mental health services are being cut because they're just not very good. The high drop-out rates say it all. So better divert the money to services patients actually want and trust.

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