I don't want choice

So the reforms proposed for the NHS rumble on with a listening exercise and much debate on whether this is the end or the saving of the NHS.

One small point that has bothered me for some time now is the chimera of choice. Much has been made of patient control and choice, that patients want choice and that choice will drive improvements in the system. My knee jerk reaction to this is that patients don't want choice, they want good healthcare. They want to be well. They don't want to be spending valuable time trying to figure out which provider might be slightly better for them.

This may be simplistic but real choice is not possible. Can I choose any provider at any time for any treatment? No and that's ok. I want to have faith in my doctors and ensure that they are the best trained, best resourced and given the support they need to focus on my care and nothing else. Not budgets, not distribution or anything else. Just care.

There is an interesting piece by Angela Coulter from the BMJ last November which tries to pull apart choice. As I read Coulter's piece there is a world of difference between choosing a provider and choosing or helping to choose a treatment plan. Here's the key quote -

Although only a small minority of people want to switch providers, patient surveys show a
large unmet demand for greater involvement in treatment decisions

So in the debate on reform at least on the issue of choice let's use our language properly and support patient engagement with their care, but let's not mislead people into thinking that they have full choice.

F