Re: Personal health budgets: surplus of cash or deficit of ideas?

17 December 2012

It was nice to see that our paper on the Dutch experience with personal health budgets was cited [1] but unfortunate that its key message was overlooked. This is that availability of these budgets is being scaled back radically, not only because of escalating costs but also because of widespread abuse.

It was also a pity that another key issue was overlooked. Many of us view personal health budgets as the beginning of a process, initiated by the Health and Social Care Bill, whereby at some point in the future each of us will be allocated a fixed amount to purchase insurance, with the requirement to top up anything that is not covered. this would be consistent with views expressed previously by various Conservative politicians.[2] what may seem like a good idea could so easily become a Trojan Horse.

1. Van Ginneken E, Groenewegen PP, McKee M. Personal healthcare budgets: what can England learn from the Netherlands? BMJ2012;344:e1383.
2. Reynolds L, McKee M. Opening the oyster: the 2010-2011 NHS reforms in England. Clin Med 2012; 12: 128–32.

Competing interests: None declared

Martin McKee, Professor of European Public Health

london School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH

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