Does the public really want choice when it comes to health care?

Political Studies is the flagship journal of the Political Studies Association of the UK and one of Britain’s longest established and most widely respected generalist journals in politics and international relations. In July 2011 editorship of Political Studies moved to the School of Politics and International Relations at Nottingham.

The third issue of the journal sees publication of research on a range of topics from video games to climate change by way of the debate over ‘realism’ in political theory, Labour’s youth citizenship programme, and the impact of conviction on policy actors. The issue opens with a paper by John Curtis and Oliver Heath that examines the impact of choice on the public’s perception of the health care they receive.

In the last decade of incessant reform of public services in the U.K., one of the most keenly contested issues has been the question of consumer choice. Do people really want choice (or just a good level of service) and does choice really deliver a better quality of service (by providing suppliers with the incentives of competition)? This is a topic that has been endlessly debated but often without a compelling evidential basis.

In their paper Oliver Heath and John Curtice provide the evidence that has been so lacking in this debate. Drawing on the British Social Attitudes Survey, they find that patients do indeed value choice. But they also find that they value this choice not as an end in itself but because they see it as the means for delivering what they really value – which is to be listened to, to be involved in their own treatment and to be treated with respect. Thus, Heath and Curtice insist that ‘the widespread demand for choice is not so much a demand for choice per se as a wish to see the NHS organized in a way that will meet people’s high expectations of what constitutes a good service’

They conclude that politicians wishing to maximize satisfaction with the health service should focus not on choice but on ‘identifying the best ways of ensuring that health professionals are attentive to the needs and wishes of their patients’.

The full article can be downloaded here and is available free online until the end of January 2013.