Health & Personal Budgets

exploring dilemmas

Dr Simon Duffy - for Leeds University

Dr Simon Duffy

•Social innovator - e.g. personal budgets

•Philosopher - work on citizenship

•Advisor - Campaign for a Fair Society

The Centre for Welfare ReformReform does not mean cuts and inequalityWelfare state is good, but designed wrongNeeds more innovation, andRespect for citizenship, families, community & justice

•Does real evidence exists for the use of personal budgets?

•Is it possible to develop and test innovations like personal budgets in the same way as we test other clinical innovations?

•Are social innovations relevant or even possible within healthcare?

•Do personal budgets open up new forms of innovatory and scientific spaces between clinicians and patients?

•From 1960s disabled people tried to convert fixed service solutions into budgets under their own control... mixed international progress

•Innovations start within communities, but then have to engage with wider policy process... e.g. PHBs

•Innovations can be supported or corrupted by many factors - they are factors in systemic changes - but they do not determine everything.

•Relationship between social innovations and institutions of validity are complex

How defined is the scope of medicine?

What makes the difference to someone’s life?

•What is the role of doctor beyond rationing medicine and surgery? If the doctor is not relevant to whom does the doctor look for other help?

•If social innovations start outside government, and are often corrupted by government what is the role of doctors or academia in nurturing them?

•What is the best methodological approach for an evolving social practice that exists in a complex, changing context?

•Is innovation possible or valuable within the doctor-patient relationship?