The government said this week it expects all eligible patients to be handed their own personal healthcare budget by 2013, and has also promised extra funds of £400 million to help give carers a break from their responsibilities.

In an attempt to inject new life into what some consider to be a floundering initiative, the government has called on councils to ensure that all patients - thought to be around the million mark - have access to a personal budget, preferably as a direct payment, to enable them to make their own decisions on how, when and where they receive their healthcare.

According to the government, the initiative can have “huge benefits” to patients as they can use their very own pot of money to elect different elements of care, such as choosing alternative methods of pain relief like hydrotherapy over conventional analgesics, or purchasing a dog specially trained to alert patients with epilepsy of an impending seizure, for instance.

“Personal budgets can make an incredible difference to people’s lives. They give people choice, control and independence,” said health minister Paul Burstow. “They look to people not the state to shape services, and improve outcomes, making a reality of the Big Society”.

In addition, the government said it will set aside £400 million over the next four years to help give carers proper breaks, so that those involved in the long-term care of patients can use their own personal budget to pursue a hobby or take a holiday, for example.

The moves form part of the government’s new plans for adult social care, which promise to extend the rollout of personal budgets, break down barriers between health and social care funding, and increase prevention in local communities, all under the wider aim of shifting power from the state to the citizen.

However, according to Pulse magazine, the pilot schemes for personal health budgets, which first emerged in 2006, have thus far “failed spectacularly to get off the ground”.

On the slow burn?

An investigation by the publication found that, despite the previous government’s £6 million injection into personal budgets, uptake in pilot schemes seems to be poor. One example it cites is NHS Havering, which reportedly hasn’t enrolled any patients even though its pilot scheme for patients with diabetes, COPD and stroke has been live since February.

Trusts are complaining of the “huge” amount of time involved, a lack of awareness of the scheme, and the potential for health inequalities between patients receiving budgets and those who don’t, Pulse reports.

The British Medical Association has also long voiced its concerns over the initiative, arguing that handing patients budgets to pay directly for national health services could potentially “undermine some of the fundamental principles of the NHS and their very existence appears at odds with the workings of the system”.

While it enables patients to better meet their own healthcare needs, the scheme could also open up yet another route by which patients could receive different levels of care, “raising significant equity concerns”, it previously warned.