Sky News led its bulletin this morning with attention-grabbing headlines about summer houses, holidays and sat-navs being funded by the NHS. Sky News didn't actually research the story themselves - that was done by Pulse magazine, which investigated how personal healthcare budgets are spent. Plenty of other media outlets have also run this story including the BBC, the Mirror,
At least the Guardian, the Telegraph and the Independent mentioned that it is Clinical Commissioning Groups - or CCGs - that are allocating the money courtesy of the personal healthcare budgets. That would be the CCGs created under the Health and Social Care Act 2012. But you'd sooner find a report about the colonisation of the moon by unicorns wearing saddles made of cheese than ever see a news report mention this act, which was passed in the last parliament by the Conservative and Liberal Democrat MPs.
Of course, the truth is rather more complicated than any of these reports imply. Credit where credit is due though - the Daily Mail, while not accepting comments on the article online, had the insight to run a decent Press Association report. This report featured an interview with a professor who pointed out that while personal healthcare budgets may seem attractive on the surface, they do reflect an ideology that is "consumerist and individualistic" and not evidence-based.
But the way this story has been largely reported serves insidious dual purposes.
1. It demonises patients in the same way that stories about misuse of A&E departments and GPs demonise patients. While misuse of A&E and GP services creates problems, it makes for cheap headlines that ignore the bigger funding issues. It is easier to mock the person who rocked up to A&E with dog poo on their shoe than get properly angry about things like the cost to the taxpayer of rotten PFI deals and administering the NHS marketplace, both of which squander billions of pounds each year.
While personal healthcare budgets are not compulsory, can we be sure that patients, especially vulnerable and elderly patients, are not pressured into joining this scheme? It has echoes of Jeremy Hunt's plan to put the price of medications on the packaging so we know how much we are costing the NHS every time we take a pill that we need to get better. This plays into the "mustn't be a burden" mentality, the fear of wasting NHS time, even if someone is in genuine need of care.
If these budgets are targeting the vulnerable, it becomes questionable as to whether they really meet the goal of helping people take responsibility for their health and wellbeing.
2. It is more NHS-bashing by the media, feeding into the public appetite for cuts. By highlighting summer houses, holidays and sat-navs, it makes people angry about profligate NHS spending and removes any subtlety from the discussion. A holistic approach to healthcare is important - and defenders of personal healthcare budgets will use this argument - but holistic treatments need to be evidence-based, especially when they are publicly funded.
Are personal healthcare budgets a sneaky way to funnel more money to the private sector right under our noses? Will patients be encouraged to use their budgets to fund private health insurance?
The Pulse report does not mention our local CCGs, which fall under the umbrella of South West London Collaborative Commissioning. But in the interests of full transparency, we have some questions for them about how they use personal healthcare budgets. As we are still fighting to keep essential services, such as A&E and maternity as well as entire hospitals open, these questions need to be answered.
If a representative from SWLCC could respond to the following questions in the comments section of this blog post, that would be much appreciated:
1. How many patients in the CCGs which come under SWLCC's administration are on personal healthcare budgets?
2. What is the average amount spent per patient on these budgets?
3. Can you provide a demographic breakdown of who uses these budgets?
4. Without naming patients, is there information available on what sort of treatments these budgets are funding?
5. What happens to a patient if their personal budget runs out and their health has not improved?
