Politicians had barely shaken the sand from their shoes or packed away the bucket and spade before they were gripped by that hardy health perennial, proposed changes to Britain’s abortion law.

It is being promoted in the Commons next week by social conservatives – and resisted with equal zeal (possibly more) by progressive supporters of the status quo.

As a Keep Calm column this one likes to warn readers that on emotive issues both sides enjoy promoting the view that civilisation as we know it will end if this or that is rejected/enacted. That is rarely a prospect. More often, the odd tweak does not make much practical difference: civilisation stubbornly staggers on.

Instead it strikes me as being about choice across a range of health policy options visible as the August bank holiday signals the return of autumn. Cancer drugs, abortion, antenatal clinics, the refusal of some foundation trusts to publish the level of patient complaints they now receive. Good choice, bad choice? That depends.

Tory MP and publicity hound Nadine Dorries is attempting to inject some “independent” options into the pregnancy advice industry – she complains that old stalwarts like Marie Stopes and the British Pregnancy Advisory Service have a financial incentive to encourage abortion. I mistrust her motives but respect her right to try to amend our old chum, the Health and Social Care Bill. Yes, it’s back!

In any case Andrew Lansley has already trumped the Dorries lobby by saying he will change rules to allow an independent (ie anti-abortion) option, being promoted by Christian groups. Another time-consuming obstacle, say progressives, when women need urgent advice now. But it’s not a US-style “culture war”.

Interesting that both sides now cannibalise “pro-choice” vocabulary. Yes, pause for a moment and realise that when it comes to, say, smoking policy, it is the progressive camp which is prescriptively intolerant of people’s right to choose self-harm. I’m on their side, but recognise there are two sides: back in power, it’s the Tories’ turn to fund pet projects, even those wretched free schools. We may even learn something from them.

When you localise choice – it’s what we say we want, but do we mean it? – there are bound to be variations. August produced a row over “do not resuscitate” policy at Addenbrooke’s Hospital amid demands that the coalition standardise procedures, as the Scottish government has, instead of letting trusts decide. Ditto that morbidly obese chap whose trust turned him down for a gastric bypass until it was bullied.

The most startling example surely lies in the survey by the Rarer Cancers Foundation showing some cancer patients in England are three times more likely to be given disputed drugs – thanks to the Lansley cancer fund – than counterparts in Scotland; five times more than in Wales. Only (only?) 200 people a year are affected. But that’s what devolution means: different policies and different outcomes, though not necessarily better.

Celtic media outrage followed. Yet a glance through the cuttings is enough to remind us that sometimes it’s Scotland that gets denied a drug, the arthritis drug RoActemra (tocilizumab), last year. However, the cry “health apartheid” is usually applied by English newspapers to English suffering, for instance over Scotland’s supposedly “free” anti-market stance on scrips or elderly care.

It may all be brilliant, it may be a waste of money – as with those middle class women who (so we read) are flocking to National Childbirth Trust classes for fear of an ailing NHS. Ministers are a bundle of contradictions. But choice is usually a good thing. That way we learn.