Health Bill [HL]

I shall address Amendment 55 in relation to top-ups. At the briefing last week, I asked whether a person who was granted a direct payment for a nurse for three days a week and wished to employ her for another two days would be allowed to top up from their private resources. Page 27 of the Personal Health Budgets: First Steps document states that, ""people may not ‘top up’ their personal health budgets from their own resources. If, for any reason, a person wanted to purchase additional care privately, this would have to take place separately"." Taking my example, if someone had a nurse daily for an hour and a half and decided that she wanted more services, so paid for an extra hour on the same morning, presumably that would not be separate and would not be allowed as it would be considered to be a top-up. I am in some dilemma as to when it is or is not a top-up and how can it be done separately if you are employing the same person on the same morning for an additional service that is not allowed in the care plan?