Clause 11
Health Bill [Lords]
2:45 pm
Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)
We want to develop a more personalised style of care from the NHS, and last year my noble Friend Lord Darzi announced a pilot programme to explore the potential of personal health budgets in his document “High Quality Care For All”. We are all aware of the success that has come from the Government’s initiative in relation to community care direct payments. We want to ensure that these direct payments will enable people to benefit to some extent in the same way that they have in community care from controlling a greater degree of their health care.
We are approaching the matter with caution. We think that it is worth exploring in a series of pilots. Giving people who have particular conditions the ability to manage their own health needs through control of the budget will, we think, appeal to a limited number of people who want to exercise the level of control over their care that is needed. We see that happening in the following way.
A patient would go to their provider—probably their GP initially—say that they want to have a health care package that does a particular set of things and then negotiate the budget with the health care provider. There may be more than one provider. The person could then ensure that that was delivered. It will not involve the handing over of money. It is about a budget being made available to meet the needs of a particular individual. Those needs may be unique; perhaps the person has a long-term disability or a particular condition. They could have control over their own lives and be able to make decisions about how and when they want particular services delivered. That must be done in negotiation with their health provider; we see that being done primarily through their GP probably, although it will not always be their GP. They will agree that process, the health care will be delivered and we shall be able to evaluate whether it has been successful. There should be about 70 pilot projects, to see how it would operate, and then we shall evaluate whether any expansion is the right way forward.
I know that the Conservative Opposition take the view that direct payments are a way, effectively, of giving some sort of private ability to control money—spend it—whichever way the person wants to. I am not sure how far the Conservatives would go with that, but I want to be clear how far the Government propose to go, and that has its limits. Where appropriate, where negotiated with health providers and where there is agreement about what will be delivered in a way that suits the personal needs of a patient with a particular condition, we want to run some pilots to see how direct payments will operate. Then we shall evaluate the outcome of those pilots before deciding either to continue with such payments or that the system had not operated correctly and that we needed to look at it again. This is a bit more than an experiment; it is a pilot that we hope will enable us better to ensure that personalised health care is delivered to those individuals who particularly need it.