Personal budgets mooted for mental health

Personal budgets mooted for mental health

Care minister Norman Lamb has said he would like to see mental health patients being given personal budgets to pay for care.

Speaking at the Liberal Democrat conference in Glasgow, Mr Lamb said: “I would like to move to a ‘right to have’ in relation to a personal budget and to extend it to mental health; giving individuals control over their health.

“You hear stories of how people used to go in and out of hospital and care constantly falling down.

“When they take control their wellbeing improves and they can stop the revolving door and improve their whole experience.”

“We should be investing in preventing deterioration of health; moving from a totally paternalistic system to one that puts people in charge.”

Personal health budgets have been piloted across a number of areas and from April 2014 anyone receiving continuing healthcare from the NHS will have the right to ask for a personal budget.

They are aimed at giving people with long term conditions or disabilities greater choice and control over their healthcare.

Mr Lamb also described the practice of not paying home care staff for the time they spend travelling to patients’ homes as “exploitation”.

He said: “Carers travelling between patients and not receiving any pay; that for me is not acceptable. You can’t deliver high quality care on the back of exploitation.”

One Response to Personal budgets mooted for mental health

  1. T McClatchey says:

    There is a lot of evidnece of personal budgets working well for SOME people with mental health problems but I have concerns about this being seen as the standard model or that and “right to have” could lead to unintended outcomes.

    Personal budgets work well for physical disabilities where health conditions are stable, needs predictable and informed service users make active choices and compromises on how they spend their alocated budgets. They have also sometimes been used to good effect in learning disability and dementia but in those cases usually require a family member/deputy/advocate to make choices on behalf of people who by definition do not have sufficient cognitive capacity to manage complex budgets. If they did, they wouldn’t need the service. While effective, these models stretch the semantic limitations of “personal budgets” in that the person receiving the service is not the prime decision making person as to how purchasing budgets are spent. We have simply replaced one external decision maker (LAs) with others who may (or may not) be more closely aligned to the “best interests” of the nominal recipient.

    Mental illnesses of their nature vary over time. They may cycle in their intensity/presentation and from a positive perspective – we should be working towards “recovery”. It is very difficult therefore to say here are your assessed needs for the next year and here is an appropriate budget that you can manage over that period. The choices an individual may make in different phases of their illness could be very different and carry the obvious risk that the “least wise” choices may be made at points where need is at its greatest. The idea of “right to have” cleary breaks down in those high expenditure areas of MH services that are applied in the context of the Mental Health Act. These services are only applicable in circumstances where the choices being made by an individual pose such a risk to themselves or others that the normal MCA expectation that adults are allowed to make unwise choices (athough maybe not with other people’s money) that the right to make one’s own choices and accept the consequences is explicity and deliberately over-ridden.

    If for adults with mental illnesses we were to follow the LD/dementia models of “3rd party” budgets, would that really represent progress or just be an easy headline for those who equate arbitrary target hitting with really improving services?

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