On Personal Health Budgets

Personal Health Budgets are looming large and will form an increasingly significant driver in the health service over the coming months and years.

I’ve often privately reflected on the leading edge that adult social care provides in public service reform. Partly because social care is relatively under the radar, it has room for more creativity and reform than other policy sectors. Thus, Personal Budgets, which have been around for some while (and their precursor, Direct Payments, have been around since 1996) are being transferred across to health, special educational needs and so on.

I have three main reflections at this stage on Personal Budgets in health.

The first is that the drive to PBs in health are likely to have a beneficial impact on the drive to PBs in social care: health very much has its head above the parapet when it comes to reform and public awareness; if PBs can be made to work there, they will be even more attractive in social care.

The second is that there is a significant level of learning from the implementation of PBs in adult social care that can be transferred to health. I hope health professionals and administrators will do the learning.

The third – and most important – is to remember that PBs were only ever one facet of one part of the overall personalisation agenda in adult social care. “Personalisation” as a whole was conceived as being made up of:

• Universal services
• Early intervention and prevention
• Social capital
• Choice and control (of which one part are Personal Budgets).

Naysayers of PBs often take them to be the only thing relating to personalisation. They’re not. Though there are undoubted challenges with PBs themselves, they are a means by which users can achieve greater choice and control. There’s a significant amount of stuff that should happen within the system besides PBs to offer a personalised, person-centred approach.

In the context of Personal Health Budgets, I hope practitioners don’t focus on Personal Budgets alone and forget about the person-centred bit, because its the latter that could drive improvements for everyone.

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