Patient budgets will 'open door to top-up fees'

The NHS Alliance warns personal budgets for patients with chronic conditions will speed privatisation.

Personal budgets for patients with chronic conditions could speed up the introduction of top-up payments and boost private-led NHS services, the NHS Alliance has warned.

The DoH confirmed last week that it would be piloting personal budgets for patients with chronic conditions after successful trials in social care.

Health secretary Alan Johnson is also expected to relax the rules on top-ups when a report by cancer czar Professor Mike Richards is published next month.

Giving patients their own healthcare budgets would mean many patients would add to them from their own funds, said NHS Alliance commissioning lead Dr David Jenner.

This could mean top-ups extend far wider than the funding of expensive cancer drugs the NHS cannot afford, he said.

'Private providers would quickly appear to offer services for patients with their own budgets to spend. They could then charge for additional services, which GPs can't do.'

Dr Jenner described the introduction of personal budgets as 'a genuine attempt to empower the patient', but said it would also 'open the door to potential top-up payments'.

Up to 35 PCTs, working with 5,000 patients, will pilot personal budgets in healthcare from early 2009.

The pilots are likely to give patients with complex, long-term conditions, such as MS, a budget to make their own health care plan, said Dr Jenner.

But GPC deputy chairman Dr Richard Vautrey said he had seen little detail and was sceptical about the merit of the plans.

'The problem is if you give someone their own budget what happens when they spend it all?

'There are potential risks and bureaucracy right through this policy.'

Dr Jenner added that practice-based commissioning consortia could eventually be given the budgets by PCTs, to help patients make decisions about their care.

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