Direct payments for health care move a step closer

MPs have backed new laws that will allow the NHS to give patients – including those with long-term conditions – direct cash payments to spend on their own treatment.
The Department of Health has already approved 70 pilot projects across England – covering areas such as mental health, palliative care, and services for people with learning difficulties – that will give patients more control over the health services they use, by giving them their own personal health budgets.
But measures in the health bill, which received its second reading in the Commons on 8 June, will allow the NHS to go further and give direct cash payments to patients.
Andy Burnham, the new health secretary, told MPs the new powers would build on the success of direct payments in social care, which had “transformed the lives of many people”.
He said the new powers would be particularly useful in bringing social care and health budgets together for people with “particularly complex health and social care needs”, and might have the greatest impact on people with long-term conditions or mental health needs.
He said there would be high quality advice and support to help people manage their budgets properly, with “explicit safeguards” for the use of direct payments and a “robust evaluation”. He said the government would “proceed with caution”.
Sandra Gidley, the Liberal Democrat shadow health spokeswoman, supported the use of direct payments, but questioned what would happen if someone with a long-term condition ran out of money, possibly because their health had deteriorated.
Sir George Young, the Conservative MP, said it was potentially “a very radical move” to a “much more flexible, user-friendly” system.
But he said there was probably a need for independent advocacy to help patients get the best value from their direct payments, and patients should not have to handle the paperwork.
The health bill has now passed to the committee stage, where it will be discussed in greater detail.
June