Going It Alone or Playing to the Crowd? A Critique of Individual Budgets and the Personalisation of Health Care in the English National Health Service

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• 作者：Iestyn Williams and Helen Dickinson
• 刊名：Australian Journal of Public Administration
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：75
• 期：2
• 页码：149-158
• 全文大小：97K
• ISSN：1467-8500

文摘

The introduction of individual budgets into English health care is a recent example of the pervasive drive towards personalisation in welfare sector organisation and delivery. As a heavily centralised and highly bureaucratic institution, the National Health Service (NHS) is an obvious target for personalisation. On the other hand, as a symbol of solidarity and nationhood it retains a powerful place within the collective psyche, such that radical reform might expect to encounter resistance. This paper analyses the assumptions that are inherent in personalisation and raises concerns over its ability to transform health-care services. At the heart of these concerns is the tension between appeals to tailored service provision and empowerment on the one hand, and promotion of a strong social contract, public trust in institutions, and collective identity on the other. Lessons are drawn for personalisation in other sectors and settings.