Personal health budgets: how would you spend yours?

Personal budgets are currently being piloted in the NHS. If these are implemented, they will put patients with long term conditions at the heart of funding decisions – allowing them to decide how best to take care of their own health needs. This could be very good news for patients of Traditional Acupuncture, who currently have to pay in order to receive this comprehensive form of Chinese Medicine. In a world where being disadvantaged materially puts you at greater risk of ill health, private holistic healthcare can only be contributing to society’s inequalities. Personal budgets could help to address this gap.

I see plenty of patients who would benefit from more regular treatment, but who cannot afford to attend. A recent poll by the British Acupuncture Council showed that Acupuncturists earned on average £15,000 per year. This is only after three years of expensive training and two more building a practice to profitability. Although many Acupuncturists would like to provide a services that is affordable for everyone – this simply isn’t possible. Providing a sliding scale, concessions and packages of care at a cheaper rate is often the best they can do.

Treatment itself may seem expensive when coming out of one’s own purse – although in real terms a diagnosis and course of four treatments (where five hours of time is completely dedicated  to the patient – one to one) costs less than one session in a hospital-based pain clinic. And herein lies another potential benefit to personal budgets – for it will make the real cost of healthcare more transparent and, I hope, put a greater onus on the people using health services to use them responsibly. Despite attempts to reduce the cost of DNAs (Did Not Attend) for example, these still cost the NHS upwards of £200 million per year. This is all money that could be better spent elsewhere.

Putting the purse strings in the hands of the patients will allow them to see that funding resources are limited – and that multiple demands compete for attention. It will also, to some extent, get round the tricky problem of prioritisation in the NHS, which has been dominated by the ubiquitous drug companies. Big Pharma can afford to conduct endless research to provide an evidence base and therefore justify a drug’s inclusion in the NHS’s list of priorities for funding. They are also very good at burying this research where it is unfavourable and therefore doesn’t suit their main end (which is to make money).

In reality, evidence based medicine (EBM) makes up a small proprotion of NHS spending. A doctor writing in the primary care rag The Pulse recently stated that only a small proportion of the medicine she provides is ‘evidenced based’. However, the NHS has to have some kind of system in place to regulate provision and what EBM provides, among other things, is grounds for refusing individual requests for funding (for Acupuncture for example) – even where patients have been having treatment and know it benefits them.

I should point out that I am not a holistic fundamentalist and beleive that western medicine is a system in its own right and a perfectly valid option that should be available. However, I also believe that ill health has multiple causes – often emotional or lifestyle based – and that people should have a choice as to how to address their health needs. Western medicine should not be the only choice available. Of course the previous government’s choice agenda had nothing much to do with patient choice – and everything to do with privitisation of the NHS. Perhaps personal budgets will provide ‘real’ choice to all, and allow the multiple causes of ill health to be addressed.

In my next blog I will be sharing my own experience of how the current NHS only allows me to deal with a health condition through the use of drugs which have multiple side effects. Whilst I have found a natural way of managing it which has no side effects – I cannot get help towards the cost. It provides an interesting case study and I hope provides support for initiatives like personal budgets…

I know how I would spend mine!

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