Whichever way you spin it, choosing a treatment from a hospital is not the same as choosing a product from a shop. If healthcare is just another part of the market, it is one sphere where the customer is not always right. No-one wants a return to the days of overbearing, uncommunicative doctors, but the philosophy of patient choice can be taken too far, particularly when the taxpayer picks up the tab.
A patient led service, where GPs are under pressure to provide the treatments people want, rather than those that they need, has its pitfalls. Thanks to the internet, we already have a whole generation prepared to second guess the advice of doctors, on the basis of their own spurious researches.
The NHS currently has some protection against the pressure of unscientific opinion and popular campaigning. The National Institute of Health and Clinical Excellence (NICE), among other tasks, assesses whether drugs are cost effective or not. Its role as an arbiter could be undermined if consortia are under pressure to provide, for example, costly cancer medication which may add just a few weeks to a terminally ill patient’s life.
There are already treatments and services, like homeopathy or female sterilisation, which the NHS offers against the prevailing wisdom of doctors, simply because the public demands them.
The government must be careful that its policies don’t encourage more waste, when the goal should be to eliminate services whose value is doubtful.
Patients must be properly informed about their healthcare choices, but it’s also important that doctors and the NHS are independent enough to withstand the latest fads and free to exercise their judgement on which treatments are worthwhile.