Healthcare Bill threatens to undermine NHS principles

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Giving patients money to buy their own healthcare paves the way for top-up payments and undermines the founding principles of the NHS, UNISON has warned as the Government published its Healthcare Bill.

The bill will allow NHS patients in England to be given cash payments to buy physiotherapy, home nursing and other healthcare.

Ministers have not yet worked out the full details of how the scheme will work or how much of the NHS’s ?100bn budget will be handed over to individual patients.

But UNISON head of health Karen Jennings warned: “There is a world of difference between giving patients greater say over their treatment, which we support, and giving them money to buy-in their own healthcare.

“Choosing the most effective treatment from a range of options is not an easy decision for patients,” she added.

“We are in real danger of creating a situation where patients use their personal budget ineffectively and then, like Oliver Twist, go back for more. Or, patients will be persuaded to top up their budgets from their own savings undermining the very founding principle of free healthcare for all.”

The scheme will be voluntary and will not cover NHS emergency services. The bill will allow pilot schemes to be set up across England this year to test the idea.

“I have no doubt that these pilots will bring to light a whole range of problems,” said Ms Jennings.

“I can see massive implications for workforce planning, NHS budgets, a two tier-NHS, staff training and development and the possibility of greater rationing.

“Against this background the pilots must be rigorous and long enough to gauge the longer-term implications. We are already seeing the damaging impact of personal budgets in social care as the results of rolling-out the system before time. We cannot allow the same to happen in the NHS.”

The bill also includes measures to:

  • require all NHS bodies and other providers of NHS services to “have regard” to the NHS constitution, due to be published next week;
  • require NHS organisations to publish quality accounts;
  • “protect patients and staff from failing NHS services”;
  • introduce prizes to “encourage enterprise and innovation within the NHS”.


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