I did feel sorry for the young man from the CCG, I have an absolute objection to Personal Health Budgets and yet I was a member of a CCG patients' group to which he was giving a presentation about PHBs. I was polite and allowed him to say his piece, and then went through the slides one by one pointing out the flaws. I prefixed my criticisms with "I know this is government policy and you have to implement them, but...". I got the impression that he had never had such robust objections before, so I was doing him a favour by giving him a taste of what he should expect in the future. I will relate one part of the conversation here.
CCG Guy: ... and with your personal budget you will be able to purchase whatever you think will help your condition, so if you think you will benefit from an acupuncture session, you'll be able to buy one with your personal budget.
Richard: This CCG regards acupuncture as a treatment of low clinical value and will not pay for it. Before the last PCT adopted the Croydon List, [the local hospital] used to offer acupuncture to people with chronic pain. After the Croydon List was adopted (and the CCG formally adopted it at their July board meeting) acupuncture is no longer available as an NHS treatment, and now it is the only private treatment that [the local hospital] offers, since chronic pain sufferers still request it.
CCG Guy: ... and this is a way that people with a personal health budget will be able to use their budget to get the treatment they want.
Richard: ... but you will create two tiers of patients. There will be those who have personal health budgets who will be allowed to use NHS money to have low clinical value treatments; and there will be the rest of us who will be denied those treatments by the CCG. Two tiers of patients.
CCG Manager to CCG Guy: Richard is right, how do we prevent there from having two tier patients?
CCG Guy: The CCG is developing a list of treatments that patients will be restricted to.
Richard: But isn't that the case already? The Croydon List. Where is the personalisation when we are told that we can only buy from a restricted list?
And the conversation went on. Basically Personal Health Budgets in a time of austerity has nothing to do with personalising care. They are a way to get patients to get used to paying for healthcare so that eventually we can be moved to a European social insurance system, just like Nick Clegg said he wanted in 2005.