Report comment

The conclusion is absolutely right. Unfortunately, choice is being waved around as an all-saving mantra by too many politicians and commentators, and its ain't necessarily so.

If you're talking about elective care and long term conditions, then the issue of much better information and patient choice has to be a central plank of any future service profile. No problem with that at all. I've sat with enough patients in EPP and Cancer Support Groups to realise that this is exactly the sort of stuff that is needed for some people.

However, what I'm seeing on my patch (and colleagues up and down the country are telling me the same) is that the real and major pressures are in A and E and unscheduled care, particularly amongst older people with complex and multiple pathologies. When it comes to these areas, the much vaunted 'choice' agenda just doesn't address the dynamics. Put simply, as a one size fits all solution its too glib and too simplistic.

Effective demand management is not a straightforward issue of leisurely checking of a brochure or website for outcomes and infection rates et al followed by a relaxed one-to-one with your GP (when I suggested this to my elderly parents, both of whom are unfortunately regular but appropriate users of NHS unscheduled care, they laughed fit to bust). Let's not pretend choice as its being portrayed is the salve for all ills. It isn't.