Comment Blog 28 February, 2019

What makes personal budgets work?

It is a simple concept. Start by enabling someone to work out what package of care, support or services they need, and then provide funding to meet that need. Personalised budgets put power in the hands of the recipients of public services and result in people getting what they agree they need, rather than just whatever was available.

As a member of the Health and Social Care Committee, I want to see people get the best possible public services, delivered in the most appropriate way to meet their needs. As a GP, I’m deeply concerned about the challenges facing our NHS and the need for integrated, personalised public services.

Public services are under intense pressure. Recently, the Committee produced a report on the Long-term funding of adult social care that foresaw a £2.5 billion funding gap for social care in 2020 unless fundamental changes are made to how care is designed and delivered. Other public services, including healthcare, are being strained by a larger population that is living for longer, often with increasingly complex health and care needs. All of this has been recognised in the NHS Long Term Plan and will surely be addressed in the overdue Green Paper on social care.

I am delighted that Reform has researched and assessed how personal budgets fit into these debates. Whilst critically considering the impact of personal budgets in health and social care, this report also looks at how the lessons of personalised public services can be applied more broadly. This includes in areas where personalisation remains somewhat distant and yet could unlock huge improvements for those people reliant upon those services, such as education, unemployment, and ex-offender rehabilitation.

The Government has pursued a strategy of personalised public services for several years now. Despite the slow progress noted in the Committee’s report on Integrated care: organisations, partnerships and systems, we must continue to push for truly personalised public services to propel the health and social care system into the 21st century. Yet the Government must now make the case for personal budgets on the basis of evidence and not principles. We know that a personalised and integrated approach to care can improve outcomes for the service users and enable informed patient choice, where public services work with people, rather than doing things to them. However, as this report shows, we need better evidence around how public services can deliver the best value for money for those funding and using them – the British taxpayers.

Our work in the Health and Social Care Committee remains one of the most important platforms for Parliament’s role in ensuring people are receiving the best public services, delivered in the most appropriate way to meet their needs. We also need the valuable work of think tanks and academics to provide robust analysis and offer external challenge to Government, with new and forward-thinking recommendations. This report provides an insight into the key issues surrounding personal budgets.

I hope you will find the insights within this paper as interesting and useful as I have, and that the Government and policymakers take note of the valuable recommendations it makes.