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Doctors’ leaders reject personal health budget concept

Direct payments for patients will undermine fairness in the NHS

OnMedica staff

Friday, 22 January 2010

The BMA has firmly rejected the idea of personal health budgets for patients to pay directly for services, in its response to a government consultation.

Plans for these budgets could undermine equality in the NHS, create more bureaucracy and divert funding to unproven treatments, all resulting in some patients not getting the care they need, said the BMA.

The Department of Health is currently exploring the possibility of personal health budgets and one option is for some patients, such as those with long-term conditions, to hold their own budget and pay directly for NHS services.

In its response to the government consultation on direct payments, published today, the BMA raised several concerns such as the possibility that these payments could result in a new layer of bureaucracy and administrative burden on PCTs.

They could also lead to an inequitable system that funded services or treatments for patients who held a personal budget, but not for those who did not.

Other issues raised by the BMA included:

  • in the event that a third party holds a patient’s budget, there would need to be safeguards to prevent exploitation
  • a mechanism could be created to allow PCTs to refuse or ration further care to patients who had spent their whole budgets
  • allowing patients to have money “banked” could encourage them to save it “for a rainy day” rather than spending what they need on their care
  • the idea of healthcare simply as a commodity would be reinforced.

Dr Hamish Meldrum, BMA chairman of council, said: “We believe in choice and flexibility for patients but these plans are worrying for a range of reasons.

“Apart from the practical difficulties and added bureaucracy involved, direct payments would take us even further towards a model where healthcare is a commodity to be bought and sold rather than something to which people are entitled. These proposals potentially undermine the principle of equal access on which the NHS is based.”

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