What brand of washing powder would Sir like?
Nobody really has a need for a thousand different types of washing powder, unless it happens to be the case that you’re physically allergic to particular brands. And similar arguments can be put forward for gas and water. Or a hernia operation.
Will the patient be aware that he has a particular congenital abnormality in his tummy wall requiring his surgeon to go in a particular route to repair his umbilical hernia?
It is hard to see how this constitutes patient choice. And also, if the market agrees amongst itself, certain providers will do the hernias, and others will do the excision of sebaceous cysts, how much choice will there be if a number of large providers settle on a ‘market price’ for these services? However, the service is essentially the same.
People who support ‘choice’ by and large say that it is not a matter of ideology, but paradoxically then continue to talk about choice as a matter of a human right. But choice must be meaningful. Choice cannot be properly exerted if you are in fact being sold a pup literally. Or it can’t be true choice if the money has run out – money doesn’t grow on trees, remember.
With the main political parties converging on various forms of the market, personal health budgets, the need for ‘efficiency savings’ (even if that leads to dangerous unsafe staffing while PFI loan repayments are made), an assumption of continued unnegotiated PFI contracts, how much choice does the electorate have?
Presumably Labour will continue to campaign on its ‘Only Labour can save the NHS’ meme, and looking around there is some justification of this with the firestorm closure of accident and emergency units here in London.
But whichever party comes into power, the question has to be: will very much change?
Personal health budgets are an extremely good example of this. The main political parties continue to tout this policy plank, with the continued maelstrom of ‘success stories’ as well as severe warnings. And yet nothing much seems to change.
The same providers promote them. The same campaigners oppose them.
Like any proposed European referendum, it is hard to know whether many members of the general public are in charge of the real facts – such as whether there are important safeguarding issues to protect people with certain types of dementia? Or to prevent people going through a manic phase of bipolar affective disorder to go through a phase of reckless manic spending?
I feel that all parties must now accept that many voters do feel severely disenfranchised, and it is hard to know how remedy this information asymmetry without, say, doing a LBC debate presented by Nick Ferrari or a BBC debate presented by David Dimbleby.
But the tragedy remains, that while we keep on being told that ‘choice is good for us’, the scope for real choice, many say being an attribute of neoliberal multinational corporate activity, is a phoney one.
