The use of personal budgets for healthcare raises many different questions about the role of the doctor and the nature of medical expertise.

1. Health & Personal Budgets
exploring dilemmas
Dr Simon Duffy - for Leeds University

2. 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
•Reform does not mean cuts and inequalityWelfare state is
good, but designed wrongNeeds more innovation,
andRespect for citizenship, families, community & justice

4. • 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?

5. • 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

6. How defined is the scope of medicine?

12. What makes the
difference to
someone’s life?

18. • 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?