Choice in health is the current shibboleth of the government. Choice is what people want. Choice is good for you. Choice will solve all your health problems. Choice will make you happy. Even health ministers with a tendency to speak in patronising and condescending sound bites talk up choice with a conviction not heard in all their utterances. Choice is what the market demands.

The National Health Service (NHS), whether we like it or not, is now a market. Private business is competing for work in primary care trusts (PCTs) and independent treatment centres. Many general practitioners now work out of premises which are leased from private business. Private investment in private finance initiative (PFI) hospitals is a well established fact. Foundation trusts (not the panacea that politicians and management think they are) will develop a corporate mentality similar to that of private enterprise.

Various agencies and opinion polls question the fervour and desire that the public have for choice in health. Most people surveyed by the King’s Fund just want a good, local, reliable, and flexible health service that is there when they or their dependents need it, but acknowledging that a minority will find a practical benefit from choice in where, when, and …