Swinging pendulums

Denplan has sponsored a report undertaken by 2020 Health entitled ‘Personal Health Budgets – a revolution in personalisation.’ This follows the government’s decision to roll out Personal Health Budgets (PHBs) in the NHS. The object of the research was to find out what the impact of this would be for the public as well as the medical profession as a whole.

I was curious as to why Denplan was sponsoring research into an NHS initiative and one with seemingly no relevance to dentistry.

They explain that they did it  ‘as it addresses an innovative, patient-centred and potentially highly effective approach to care – exactly the type of approach two dentists took to the provision of dental care, when they founded Denplan in 1986’.

In a foreword to the report Roger Matthews, Denplan’s chief dental Oofficer explains the reports relevance to dentistry by saying that if capitation is introduced to NHS dentistry primarily as a means of remunerating dental professionals it is likely to have ‘unintended consequences’.

On the other hand if it is ‘a means of influencing behaviour change in health care professionals and patients, and to usher in a truly preventive approach, it may succeed, but only if the autonomy of patients is respected and incorporated’.

So, with the new contract pilots in mind, which way is the pendulum likely to swing? I am pessimistic. Far from giving patients autonomy over their care, commissioning of services is firmly in the hands of NHS England. They will be treated according to a care pathway imposed from above.

Despite the fact that patients pay a high proportion of their treatment costs, they have no say in how it is delivered. 

By contrast in a Personal Health Budget, they are given a sum of money (typically up to £500) that can be used for example to buy exercise equipment or gym membership with personal health trainer, perhaps slimming club membership, a mobility scooter or even a pet (as company for MS sufferer).

In his speech to the BDA conference, Earl Howe stressed the need for patients to be involved in their own care. This will never happen while NHS England maintains iron control over the means of delivery and the budget.

By news correspondent Michael Watson

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