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Personal Health Budgets

Pulse Magazine, which serves GPs, published a brief report on Personal Health Budgets (PHBs) which picked up enormous media attention by focusing on the use of PHBs on supposedly inappropriate expenditure. Its headline was:

"NHS allows patients to splash cash on holidays, summer houses and Wii Fits."

This led to a frenzy of coverage in newspapers, radio and on TV, into which The Centre for Welfare Reform was drawn, because Dr Simon Duffy, Director of The Centre, had originally invented personal budgets (which have now been extended to the NHS in the form of PHBs).

In summary Dr Duffy said:

"It is a shame that leading figures in the medical establishment have decided to take such an aggressively negative stance towards what is a small and potentially powerful area of innovation for the NHS. It seems disrespectful to patients and to their colleagues and fellow professionals in the NHS to share examples of unusual or creative expenditures - with no explanatory context. They are making judgements without the necessary evidence."

"At their heart PHBs are just one mechanism for sharing power between professionals and the citizens who pay for and are entitled to use the NHS. Doctors do not always know best, and much of what is done by the NHS is based on habit and history - not evidence. Offering people the chance to change how resources are used, in ways that respect the reality of their life and their community makes sense."

"Ultimately it will not be people like me who will persuade professionals to citizens of the benefits of innovations like PHBs. Professionals need to be persuaded by other professionals; citizens will be persuaded by citizens who have benefited from them. I hope the NHS leadership learn the lessons of this experience and think carefully about their strategies for developing and implementing innovations like PHBs. Good innovations are often killed by poor implementation, and PHBs must be supported by a sustainable strategy and a focus on partnership with clinicians."

Dr Duffy has written an article for the BMJ on why clinicians should welcome innovations like PHBs:


Following the furore of media interest Dr Duffy also wrote a blog on the underlying issues for the Socialist Health Association, of which he is a member:


You can also find numerous articles and reports on the use of personalisation in the NHS on The Centre for Welfare Reform's website and on the Right Hand Side of this page.