U.K.: Choice between tweedledum and tweedledee fails to please

The Government’s choice agenda in the National Health Service is failing to satisfy patients, according to a survey. Released by the British Medical Association in Belfast as it assembles for its annual meeting, the survey suggests that NHS patients want to have choice, but would prefer choices other than those being offered by the Government. As a result, 55 per cent said that the NHS did not offer choice — even though the Government has extended its policy of providing a choice of hospitals. Patients can choose from five places to have operations, usually including at least one private-sector centre.

When participants were asked what choices they wanted to be able to make, 69 per cent said it was very important “to have a say in things generally”. Almost as many chose “timing of treatment”, then a choice of GP, type of treatment and specialist, in that order of preference. Just over half of the 1,077 adults interviewed by Andrew Irving Associates for the survey said they thought that choice of hospital was very important. Nearly a quarter said that hospital choice was the first thing that occurred to them when considering choice in the NHS. Only 7 per cent said that a say in things generally was on offer, even though that was what the majority of participants said that they wanted.

James Johnson, chairman of the BMA Council, said: “Patient choice is on the lips of every politician and drives the NHS reform agenda. “We wanted to find out what it means for ordinary people and how important it is to them. We found some suprising results which don’t seem to match government thinking. Most strikingly, the majority of people said that the NHS did not offer choice. “The concept of choice is very popular, but people’s priorities aren’t in line with the Government’s. The majority who thought there was no choice have either not been listening to the propaganda, or have been listening and haven’t been impressed.”

NHS reforms are set to have a high priority at this week’s conference, with a lengthy debate tomorrow on the reform of the NHS in England, followed by votes on detailed resolutions on the subject on Wednesday. “It’s a central issue for us and this is a very timely moment,” said Dr Michael Wilks, who will chair the conference. Other contentious issues to be discussed include the advertising of food and drink, putting GPs’ surgeries in supermarkets, the NHS IT system, education and training of doctors, and euthanasia.

Doctors are expected to express strong views on NHS deficits at a time when NHS spending has doubled. Some troubled hospitals have sought cuts in staff levels that could affect doctors. Mr Johnson reacted to reports that the Oxford Radcliffe Hospital had made two consultants redundant by saying that any redundancies among doctors would be “absurd and ridiculous”. Britain still had too few doctors, he said. “The whole emphasis of the Government’s policy has been on increasing doctors and medical students. It is a huge waste if it is going to pay to train doctors and them make them redundant. “We’re not prepared to see valuable assets wasted,” he said. “We will do everything in our power to help any doctors threatened with redundancy.”

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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