Tag Archive: patient choice


Health Secretary Andy Burnham has announced plans to scrap GP catchment areas in England within a year. It follows a claim that ministers want to introduce greater choice into the family doctor system, as they believe that it will drive up standards. The government has trying to get more from GPs ever since their pay rocketed with the introduction of a new contract in 2004. It started with GPs staying open for longer but the idea of ending catchment areas was on the cards before Gordon Brown became prime minister. Lord Darzi mentioned the idea when he revealed his review of the health service in 2008. At the moment catchment areas vary in size; in rural areas doctors see patients up to 40 miles away whilst city-based doctors often only see patients up t0 a 2 mile radius

Patient choice is already a well established right in hospital care with people entitled to choose from any hospital in the country for treatment. Mr Burnham states: “I want the best to be available to everyone, not according to where they live. Too often people’s choice of GP practice is unnecessarily limited by practice boundaries, so, with the profession, I want to open up real choice in primary care.” He also argues that people’s choice of a GP should be based on their own needs – not by lines on a map

Personal budgets have been used in social care since the mid 1990s and ministers claim that they can encourage patients to get more from the NHS. Evidence shows that personal budgets have allowed people in social care to be more imaginative and use funds more “carefully” than the system did. It is said that the personal budget programme employed in social care includes direct cash payments to the individual as well as budgets that a patient can put in the hands of a social care professional.

Those who support the idea of patients having their own personal budget have said that there is no reason why this should not happen in health, although it will need to be carefully introduced.

There are those who claim that the system who say that the system can be misused if you are simply giving patients money however the information on this scheme states that where direct payments are handed over to individuals the way they are used is carefully monitored and people receive help from professionals about what services are available. The chief executive of the NHS Confederation, which represents managers, states: “There is a growing body of evidence to suggest health outcomes are improved when the patient is directly involved in making decisions about their treatment and the way in which care is delivered by NHS staff.” Despite this there are a number of obstacles to overcome before the scheme can be launched nationally.

There are lots of questions from those who have their doubts about this new system such as, should patients be allowed to spend their personal budgets on non cost-effective treatments? or should individuals be allowed to top-up their care? Should patients be allowed to invest personal budgets to be spent at a later date? Dr Hamish Meldrum, who is the chairman of the British Medical Association, said the policy appeared to “further establish the idea of healthcare as a commodity”, which would not be in patients’ “best interests”.

Those who support the idea of patients managing their own budget claim that “Personal health budgets could revolutionise the way in which care is delivered, but they are not without risks.”

Niall Dickson states: “Getting the initial payment level right will be important as will deciding what restrictions to place on the kind of treatment a patient is allowed to purchase with tax payers’ money, and from whom.”

Ministers imagine that it will be of particular interest to those with long-term conditions such as diabetes and people using mental health services, for example, a person with diabetes may choose to use their budget to get treatment from a community clinic rather than being referred to a hospital specialist. Launching the Bill, Health Secretary Alan Johnson said: “People rightly have high expectations of the care the NHS offers, and they want more control over their own health – which is why this Bill will give more power to patients and drive up the quality of care.” Andrew Lansley adds: “Personal budgets have been at pilot stage since 2005. If Labour had stuck to their promises to deliver them then patients would already be benefiting”.

It would seem that the majority of people are dubious of this new scheme as it seems that they are worried about several factors:

  • It is essentially privatising the NHS
  • Some people may get a higher budget than others
  • Some people may use their budget to jump through the waiting lists for procedures

Without a detailed plan of how the scheme will actually work it is impossible to know whether the scheme will actually work basically I’m not sure if the scheme is good or bad. Although the evidence would suggest that there is the potential for the scheme to work I think it may cause some people to lose out or be unable to get the treatment they need.

We’ve all seen the media items on this topic but what exactly does it all mean?
According to some articles the UK’s Department of Health (DoH) is seeking urgent help to create a failure regime in the National Health Service, this is because the NHS is apparently over budget in several areas but this can’t be resolved through shifting the managerial responsibility in other words you are simply shifting the problem rather than solving it. Politics of today states that there is a noticeable commitment to the virtues of private enterprise and competition in the free market. However, there is no need for the government to relinquish control of the NHS. General health care for all is a widely accepted as a right in this country. If the government wants to improve the NHS they should raise taxes in order for the public to raise the standard of a national health care service for all. People have always paid for public services through taxation“ this is not a new radical solution. However in the current situation people will resent an increase in taxes as the prices are increasing as a result of the “credit crunch”. The nature of private businesses creates an environment of competition, as a result resources and facilities as companies compete for “business” and consequently facilities and services improve. These “funds” are essential to the NHS system can only raise the standard of treatment patients will receive.

On the other hand the privatisation of the NHS will result in an emphasis on efficiency and profit; the vulnerable and the poorest in society will suffer from such a scenario. The question of prioritising health care and rationing will always favour the rich, since targeting vulnerable groups will be an inefficient use of resources so it will result in the poorer people within society suffering as they will be unable to afford adequate healthcare this will create a vicious circle because the poor will perish then the next “level of in income” will become the poor and so in until eventually you end up in the same situation that you started with. So ultimately “you’re damned if you do and you’re damned if you don’t” because you need the funds to resolve some of the issues within the NHS but then a large percentage of society suffers if you privatise so either way you can’t win.