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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 30; 334(7608): 1343.
PMCID: PMC1906636
BMA annual representative meeting, Torquay, 25 June to 29 June

Choice for patients can worsen quality of care

There is no evidence that giving patients the ability to choose where they are treated improves the quality of care, a survey on the Department of Health's own website showed.

An emphasis on choice could also increase inequality by favouring the more affluent and more articulate patients, BMA representatives heard at their annual meeting this week.

Terry John, from Waltham Forest, told the audience that the survey appeared on the website late last year but was removed just a few weeks later because, it was said, the views were not those of the department and the NHS logo had been used without permission.

Representatives agreed in a motion that the idea of patient choice does not offer real choices and insisted that the Department of Health work with the BMA and patients' organisations to identify patients' real needs.

Dr John said that the priorities for most patients were to be involved in decisions about their management, to be treated with dignity and respect, and to have their views listened to.

“We do this every day—that is where the real choice is going on,” he said.

He said it was paradoxical that patients had had no choice about the introduction of patient choice, and he added, “Isn't it time they had one?”

Representatives also agreed overwhelmingly that Choose and Book, the electronic referral system by which patients can choose the date, location, and time of hospital appointments, was currently unfit for purpose, actually limited patients' choice, and should be suspended until “such time as the system is efficient and effective.”

Consultant gynaecologist Alan Russell said that his private practice had been booming recently because so many patients who wanted to see him on the NHS were unable to do so through Choose and Book.

Mr Russell said that he had to reject about half of the patients referred to him through the Choose and Book system because they were referred to him inappropriately.

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