Dr. Jamie Wilson talks about the introduction of Personal Health Budgets, the positive impacts it may have and the various oppositions to the change.
Personal Health Budgets and the medical establishmentIn April this year, 56,000 patients receiving NHS continuing care will be among the first to receive personal health budgets. In September 2014, any patient will have the right to request a personal health budget from their CCG, the local bodies that oversee NHS expenditure. These proposed changes are groundbreaking, as for the first time in NHS history, healthcare expenditure will be put into the hands of patients and their carers, overturning conventions about who controls the purse strings. But these changes have stoked controversy as there have been reports of patients using their budgets for activities such as theatre visits, alternative therapies and ready meals. Now Pulse, a GP magazine, has reported that personal health budgets will not lead to better health outcomes and will only benefit "assertive" (read: pushy) patients. Therefore, the thinking goes, no patient should have control over the health budget as this will amplify healthcare disparities. Of course, it would be fine if the £100bn plus NHS budget were currently spent in a way that fitted individual patient needs, but that is obviously not the case. Just to give one example of a carer who contacted our site:
Carers need support to enable Alzheimer sufferers to have the best possible life. At the moment what is available? My other half has early onset dementia and we are just coasting along, no support, apart from a 6 monthly memory test with a practice nurse! Surely there should be some kind of therapy, to stretch the mind, and use parts not yet affected. Something can surely be done.
At the moment, this person has no means of seeking alternatives as the system paternalistically and inflexibly determines what will be given. It would also be fine, if GPs who have most to lose both financially and professionally, had well reasoned arguments for denying patients the right to their own health budgets. Sadly not. This is one comment from a GP on the Pulse site:
I work in the deprived area 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.
So why does this mean that 60 million other patients should not have the means to determine their health and wellbeing? As one patient said in response:
Let's face it - GPs real opposition to personal health budgets is that it challenges their 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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