too much choice

Posted in: Patient choice | Acute Care

20-May-2009 6:33 pm

Posts: 1

Perhaps the New Labour Government needs to step back from its middle class agenda and consider whether choice is really what most people want - and more about what the middle classes want for themselves. Perhaps what most people want is good health quality care that is accessible and flexible when they need it and where they live, rather than being a series of decisions that are daunting and difficult.

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20-May-2009 6:48 pm

People do want choice but some don't realise they have it (ie to be able to go to any hospital they want) or what services or choices are available to them.

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Anonymous

30-May-2009 7:10 pm

Oh people do want choice do they?

If I am ill I just want to be fixed, preferably a place near my home.

I don't want to have to choose - I just want to be made better.

'Choice' and 'involvement' are things that are designed to take the focus away from getting what matters. We can't improve the service, but maybe if we turn it into a free market thing it will lead to better services. Wrong - that's just dumb ideology talking!

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Jonathan Green

Posts: 1

17-Jul-2009 6:28 pm

Possibly some people who are mildly ill want choice but personally I would not.

My first reason is that I am unlikely to have access to useful data to make the choice. After all what is a full dataset for that choice? For starters I suggest that it would have to cross-relate all of the following : my genetic, and environmental factors the skills of all the health staff involved, their culture and ability regarding communications, the quality of the equipment and medication they have access to and their familiarity with that equipment and medication. I suppose studying all of that to reach a meaning fill comparison would take 18 weeks.

But if i am seriously ill - I want experts to take the problem away I don't want to be woken up to chose the type of heart valve or which external bone fixing is used.

I speak as a member of the public now but also as a one time nurse and healthcare manager. I have never met anyone who valued choice in serious healthcare. The people I talk to want an expert service with capacity to see them in time and capable of making the best possible decision as quickly as possible.

Another factor defeating rational, informed choice in healthcare is the Department of Health's continuing push to privatise healthcare, this is driving the providers to see their interests as competing as that happens the providers will:
1) develop costly duplication of capacity to allow them to increase income
2) distort available information to gain customers as they do in the rest of the free market - it is called advertising.

So i suggest that in a state healthcare system choice is an unnecessary burden, in a private healthcare system choice is unavoidable, costly and meaningless.

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Anonymous

9-Oct-2009 11:42 am

I agree with Jonathan that choice is something we are being fobbed off with, while we are busy making our choices, goal posts get moved, and having a choice becomes meaningless.

As a society, we have been encouraged to be consumers - the demand for healthcare was there before the introduction of choice and the free market. With free market taking over, each organisation is expected to compete and instead of giving us better services, managers are encouraged to increase budgets in the hope that a particular organisation will not have its budget cut for the next year. Together with the introduction of the free market into the NHS, and political interference at every available chance, the NHS is a playground for egotists.

The NHS could be much better managed if we got rid of political interference: I do truly believe this - the system of targets has means that there is a shift to provide care within a specific time - this leads to increasing tension - quality of care cannot survive if we keep going on about targets.

The incentives within the NHS means that you get rewarded for achieving targets - it does not take into account that individuals recovery rate will depend on various factors, the main one being co-morbidities. But try telling that to those who make the rules, and set up the incentives - those who have no experience of any hardships, living in their ivory towers, complete with duck ponds, have no idea what they are doing, but they have the power to make decisions which have an effect on us all as taxpayers.

Promising health and health care for all is one thing, delivering the services is a much more complex process - but politicians have no time for that, they only want news that will grab the headlines.

And unfortunately, those with little experience, but with friends in the right place are making the decisions for us.

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