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Patients 'should manage their own NHS budget'

11/04/2008

Patients with long-term, chronic conditions should be given money to organise and purchase their own care, a health expert has argued today.

Vidhya Alakeson, an expert in healthcare policy at the US Department of Health and Human Services, says direct payments would give patients a greater say over the types of treatment they receive and could improve satisfaction and outcomes.

She adds that individual healthcare budgets could also reduce costs for local authorities and allow services to be more accurately tailored to individual needs.

Direct payments for social care were introduced in the UK in 1996 and are available to disabled adults, the elderly and carers of disabled children.

Writing in the British Medical Journal (BMJ), Ms Alakeson acknowledges that there are a number of doubts about giving people say over the costs of their care.

These include the capacity of people without clinical training to make sound decisions about complex areas of healthcare and that it could encourage fraud and poor use of scarce NHS funds.

But she argues that evidence from pilots in the US suggests "much of this scepticism is misplaced".

"Choice of provider has been a central part of much of the policy discussion in the UK and internationally in recent years," Ms Alakeson said.

"But provider choice is only one dimension of health care. Individual budgets extend patient control over the who, what, when, and where, and, critically for long term conditions, give patients greater say over the types of treatments and services they receive."

She added: "The time has come for governments to match their rhetorical commitment to a patient centred healthcare system that delivers high quality, integrated care for long term conditions to a real commitment to pilot individual budgets in health care."