I must say I agree with Mr . Leger's comment (http://www.bmj.com/cgi/eletters/338/jan20_1/b210) on personal health care budgets pilot in the UK. He argues that they don' necessarily bring only good.
As today's and future care becomes more and more complex and integrated, chopping down services to units to be 'purchased' by end-users (as the proposal goes) doesn't make sense. At least in long-term care.
To be efficient (and effective) long term care must be integrated and tightly coordinated, often involving different health care professionals and even different HC providers.
Money following the patient, yes. But in a way that also avoids perverse incentives to the health care providers (like increasing numbers of visits, increasing drug prescriptions on the account of other possible but more time consuming interventions such as education etc).