Can giving patients choice really be cost effective for the NHS?

By Richard Meade
Head of Policy and Public Affairs in Scotland

Marie Curie fringe event at the Liberal Democrat Party Conference



This was the question we asked a panel of politicians, health professionals and policy experts at the Liberal Democrat Party Conference in Glasgow on Monday 16 September.


The party conference season got off to a flying start for Marie Curie, with standing room only at the fringe event we ran jointly with Sue Ryder and Help the Hospices. This is the first of three such events at each of the main party conferences.

Panellists included Norman Lamb MP, Minister for State for Care and Support, Paul Burstow MP, Mark Thomas, Assistant Director of Policy at the Royal College of General Practitioners and Tim Brett, part of the leadership team at Fife Council. The debate focused on the need to balance greater choice for patients with cost savings.

With the total number of annual deaths expected to rise by 17% by 2030 to almost 590,000 deaths per year, NHS spending on end of life care is set to increase from £5 billion to £25 billion. This represents a demographic ticking time bomb for the NHS. But evidence from Marie Curie suggests that enabling people to choose where they die, whether at home, in a hospice or in a care home, can save the NHS money.

Norman Lamb spoke in favour of giving patients more choice and moving away from a “paternalistic model of care”. He argued that, too often, patients spend their last days in hospital when they don’t want to be there and acknowledged there is a link between giving patients a choice and saving money.

The debate moved on to greater integration of the health and social care systems as a way of both reducing costs and improving patient choice.

According to Norman Lamb, 3.8 billion has been set aside to support this process in England. He spoke about creating “integration pioneers” in 15 local authorities to model a better way of working. In Scotland, legislation is currently going through to integrate the health and social care systems more closely.

Personalised health budgets were also discussed as a way of giving patients greater control over their own care.

Overall, the debate was very encouraging. It shows that, from a Liberal Democrat perspective, the political will is there to improve end of life care. We are hoping for an equally positive response at the Labour and Conservative conferences over the next month.

Read our blog post from the Conservative conference

Read our blog post from the Labour conference