The government has unveiled a radical expansion of patient choice and a major overhaul of care services to give the elderly and disabled patients control over a new personalised budget.

The twin proposals are the latest in a string of new initiatives Labour has unveiled in recent weeks as it attempts to convince voters of its NHS policies ahead of the general election in May.

Proposals in a green paper give individual budgets to people who use social care and other local authority services so that they can buy-in the services they need.

Health Secretary John Reid said: "Social care should be about helping people maintain their independence, giving them real control over their lives and giving them real choice in the services they use. Services must recognise the changing world, our changing attitudes and our ageing population."

Other plans include the appointment of directors to co-ordinate adult social services and improving working relations between the NHS, voluntary and community sector.

Help The Aged said it welcomed the drive to give people independence, greater choice and control in meeting their care needs. But Paul Cann, the charity's director of policy said: "We must break out of the cycle of responding too late and expensively, to people's needs and to do this the cut in low level services must be reversed."

Meanwhile, the NHS Confederation, which represents more than 90% of NHS organisations throughout the UK also welcomed the plans but said PCTs should be allowed to focus on improving these services and not managing renewed internal change.

The government have tried to wrong-foot the Conservative party and its claims that much NHS investment has gone to waste on increased bureaucracy by abolishing or merging a number of NHS agencies, and cutting thousands of jobs.

Dr Reid recently announced this has already saved £150 million, but the NHS Confederation fears similar rationalisations in PCTs themselves could jeopardise improvements to services.  

Chief executive Dr Gill Morgan said: "A key part of this agenda will be ensuring that PCTs do not find their time diverted by yet more focus on structural changes and mergers so that they can concentrate on developing local strategic partnerships to deliver service changes - those partnerships need to be given time to develop trust and good working relationships.

"There are already some really exciting examples of good integrated services which are offering personalised and responsive services for users and carers," she said.

The health secretary's plans for patient choice also encompass a further extension to the Choose and Book scheme for patients needing elective treatment such as for cataracts and hip replacements.

The NHS is still preparing for the introduction of the system whereby patients choose from up to five hospitals, to be introduced in December but the government has now announced a rapid expansion of the choice from April 2006.

Patients will be able choose from as many as 50 hospitals, from the full range of providers ­ foundation trusts and private sector among them - that meet certain standards.

The expansion in choice is intended to greatly increase the level of competition and stimulate the creation of more foundation hospitals, which the government believes will create faster and better patient services.

The rapid introduction of the system has been opposed by the BMA and many doctors, with the National Audit Office warning earlier this year that problems with IT and finance mean the planned December introduction of the scheme could be missed.

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Tuesday , March 15, 2005

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