A consumer-driven health system is better than being finance driven, but I think I would prefer practice-led even over patient-led. Maybe doctor doesn’t know what’s best for me when it comes to independence, choice and risk but I am happy to defer on medical issues.

‘I don’t want to be a consumer. I am happy to be a patient. All I ask is that my nurse, GP and consultant treat me like an adult capable of making decisions about my own life’

As for personalisation, it is well established in social care and has only a limited success: excellent for people with a disability who are articulate and assertive provided the budget is sufficiently generous to meet their needs in the way they desire; totally inappropriate for people with dementia and those offered a budget that is theirs to spend as they see fit but insufficient to meet basic needs.

Recurring nightmare

A nightmare because if you don’t trust your GP or consultant who do you trust?

A nightmare because you just don’t have the energy to research for the “best” provider and negotiate a package of care.

A nightmare because the prospect of employing carers and sacking them just makes you anxious.

A nightmare because trying to manage an inadequate budget just adds to your stress. And what happens if your needs change, the provider goes out of business, the eligibility criteria changes and your personal budget is reduced or withdrawn?

I don’t want to be a consumer. I am happy to be a patient. All I ask is that my nurse, GP and consultant treat me like an adult capable of making decisions about my own life.