Published: 24/03/2005, Volume II5, No. 5947 Page 8

The Commons public administration committee has urged the government to take a more 'realistic' approach to public choice.

Choice, Voice and Public Services says that choice is not necessarily the public's highest priority. It warns that frequent users of public services are more interested in practical choices, such as direct payments for social care, than choice of provider.

The report suggests that the NHS should not offer the private sector guaranteed levels of business, as this could lead to inefficient resource use. It was published last Thursday as NHS chief executive Sir Nigel Crisp announced a move away from 'volume guarantees' for the private sector (news, page 7, 17 March).

The report also calls for a strengthening of the 'voice' of patients in the running of public services. But it flags up a number of tensions in this area.

In particular, it suggests that 'the omens look uncertain' for the future of foundation trust boards, given the tone of health minister John Hutton when he gave evidence to MPs.

Mr Hutton told MPs that concessions which led to the creation of these boards were made 'because that is essentially what many of our colleagues asked us to do'.

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