User groups have criticised government plans to introduce direct payments into healthcare as being too restrictive.
Shaping Our Lives and the National Centre for Independent Living (NCIL) are both worried that access to payments will be limited and users will face too many conditions in their use of payments – far more so than in social care.
Direct payments are due to be introduced under the Health Act, with pilots expected to run from 2010-12, as part of a wider pilot programme on introducing personal budgets to the health service to increase choice and control for patients.
Peter Beresford, chair of Shaping our Lives and professor of social policy at Brunel University, said: “We have concerns about the way in which the strengths of personalised budgets, which is the chance to gain control, will be qualified by them being much too narrowly prescribed.”
Beresford said he thought the problem was related to an old “command and control” structure in the NHS but said he was hopeful that “policymakers will realise the problems”.
Shaping our Lives, along with NCIL, has been involved in the pilot process.
Both groups are concerned about proposals for primary care trusts to carry out Criminal Records Bureau check on anyone employed by a patient to care for them who is not a friend or family member of the patient, or a member of their household.
There is no such obligation on councils in relation to people hired by adult direct payment users so long as they possess capacity.
Another concern voiced by the groups is that PCTs appear to have the right to decide who the individual hires before it agrees a care plan.
Direct payments are one of three ways in which personal health budgets will be tested, as part of the pilot programme, the others being:
• a notional budget held by a commissioner, such as the patient’s doctor or primary care trust.
• a budget managed on the individual’s behalf by a third party, like a charity.