Friday, September 18, 2009

Choice is not the issue, especially in health care

Choice is surely the weasaliest word in the modern politician's lexicon. Has choice made our education system better? No. Has it met the pushier aspirations of the handful of middle-class marginal voters who decide elections in our first past the post electoral system? Yes.

I've argued before that when it comes to health care, choice is the reddest of herrings. Yes, the opportunity to register with whichever GP is more convenient makes sense, as health minister Andy Burnham outlined yesterday but if it is accompanied by league tables or some other ludicrous 'performance indicators', it will only increase the risk of a two or even three tier health care system.

If resources follow patients what will happen to the health outcomes of those left in the less popular practices? And in what parts of the city will those practices be, do you think? Let's talk Glasgow, as an example. Are these popular practices more likely to be in, say, Calton, a deprived part of Glasgow with a male life-expectancy of just 54 or in those parts of the same city where the life-expectancy is already 28 years longer? Come on, Mr Burnham, the clue's in the question.

So let's talk about what really matters in health care. More choice never made any sick patient feel better. Quality treatment does. And that should be available to everyone regardless of who their GP is.

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