Health Bill [HL]

I shall speak briefly to Amendments 55 and 56. An issue flagged up earlier this afternoon was what happens when the amount of a direct payment runs out? If someone is in receipt of a direct payment and then discovers that it is insufficient to pay for the healthcare that is needed, two risks arise. First, the person will not receive the care that is needed and, secondly, he or she might regard the budget as something to be adhered to at all costs and start self-rationing to keep within it. What will be done to ensure that recipients of direct payments are not put in that position, which could arise even with treatments for a long-term condition that is stable and predictable? Will the Minister confirm that the fact of a personal budget being fixed at a set amount does not mean that the NHS would not step in and either top up the budget or pay for other treatment if that was clinically indicated? The second issue refers to clawback. How practical would it be in a given set of circumstances to claw back money that has already been paid out? How would that be done? Would it not be better to allow for unspent portions of personal budgets to be carried over from year to year if the care plan allowed scope for that to happen?