The government is considering offering patients with long-term conditions such as diabetes, multiple sclerosis and motor neurone disease their own personal budgets to give them more control over their care and treatment.

The move, which was first discussed by Health Secretary Alan Johnson in an interview with The Sunday Telegraph this weekend, mirrors a pilot scheme currently underway in England and Wales to provide the elderly and disabled with social care budgets to manage their own care, and marks an extension of the government’s current choice agenda, a key aspect of healthcare reform.

“Surveys show that people want more choice and this represents a big change in how the NHS traditionally has been seen. People still think choice is something for the private sector, but we want choice for everyone within a world class NHS”, Johnson said, explaining the drive.

The Department of Health has since confirmed that, as part of Sir Ara Darzi’s Next Stage Review of the National Health Service, the idea of individual budgets for people with certain long-term conditions - where care and quality of life could be improved - are being considered, and that, if the Secretary of State decides to go down this avenue, the next likely steps would be pilots and stakeholder consultation.

But, in an emailed statement, the DH also stressed that, as the idea is very much still in infancy, it could offer no details as to how the scheme might work, although it did say that personal budgets would not entail “vouchers or dishing out cash to individuals and we would not be talking about taking money outside the NHS”.

Plans welcomed
Response to the planned NHS budgets has been largely positive. Liberal Democrat Shadow Health Secretary Norman Lamb agreed that care budgets have been a success in social care and could be just as successful for dealing with long-term illnesses. “But the government must get on with giving patients and their families control, rather than endlessly talking about it,” he added.

MS Society chief executive, Simon Gillespie, was also enthusiastic about the plans. “This is an opportunity to provide people with MS with the effective care they need when they need it and in the most appropriate way,” particularly as needs can change from week to week, he said.

“If [patients] have control over their own care budget, they can choose the most effective support package,” he added, but emphasised that patients need to be able to make informed choices about their care “based on reliable information and guidance”.

But the British Medical Association has voiced concerns over the move. “Patients currently do not have always the information they need to make fully informed decisions about their treatment, and even if they did, some might need help interpreting it yet doctors and nurses themselves often don’t know about the specialist care facilities that are available in particular hospitals,” said Dr Laurence Buckman, chairman of the BMA’s GPs Committee.

Furthermore, he also warned over the potential destabilising effect this may have on the NHS, as hospitals will lose funding if patients decide to go further afield for their treatment. “Devolving funding decisions down to the level of individuals is potentially quite dangerous. It could effectively mean individual patients competing with each other for budgets,” he stressed.

Under a separate aspect of the choice agenda, patients will, from today, be able to choose to have treatment in any NHS-providing hospital across the country, in a move which the government hopes will help to improve quality and standards across the service.