I recently read an article in the Times newspaper which reported that personal budgets for health and social care were to be expanded from about 20,000 to over 300,000. People would decide on their own package and this would be reviewed by a doctor to ensure value for money and that it would be effective.
But what would they class as an ineffective treatment? Also articles about personal budgets don’t include issues such as client own contributions (which I think are systematically too high), NHS treatments are free at the point of need but sadly social care is not. I once heard the words (I don’t remember where from) nobody knows the disability better than the client themselves. I would ask the question “Just how different personal budgets could be from the Independent living Fund model (ILF)”. That to me was the best model for NHS care but this was deemed un-affordable in the long run so what is the differences with personal budgets? The clients own contribution I feel makes it different. The Government seeks to pay the money in benefits or such things as personal budgets but not both at the same time for an individual. I can empathise with some older people not wanting to engage with the personal budgets model but if they seek good carers then their engagement is needed in some form, or by their relatives or friends. I am going to try to give you an example of where a personal health budget would not work for me. Cognitive Behaviour Therapy (CBT), because of my existing MS rules this out for me, but this is a recognised treatment by the NHS. What has really help me with my mental health problems and issues is Neuro-Linguistic Programming (NLP), a form of hypnotherapy, but this is not officially recognised by the NHS. Also I have learnt of a study of NLP which took place which meant NLP was ruled as not being effective for people with autism and I have autism, so if I was on a person budget based on what I have just told you would an NHS doctor approve me for NLP? I have my doubts, plus I would have to pay towards a personal budget out of my benefits so to spend the rest of my life in limbo with a very complex long term health conditions, including Post Taumatic Stress Disorder (PTSD), I doubt a personal budget would work in practice for me.
It seems the doctors would have the final say in what is being proposed but no indication of what happens if the client disagrees or dislikes what the doctors does or does not allow. Will there be any form of arbitration or advocacy offered on the doctors decisions?
As for those that say personal budgets would lead to a privatisation of the NHS I am not sure how it would work out and if it would be a bad thing. I don’t think the existing model of the NHS and social care can be sustained.