Mike Fitzpatrick1 is correct. The perverse truth is that inequity is a necessary precondition for choice to be meaningful.
The choice evangelists try to repel their critics by quietly conflating consumer choice with moral choice and rights talk. It is important, therefore, to distinguish between consumerism (the preoccupation with, and increase in, consumption), and moral choice (the patient's inalienable authority to give and withhold consent).
If patient choice drives quality and empowerment, to where is it driving it? A state of equity, and satisfaction for all, by way of the necessary evil of market forces. Who said Marxism was dead?
- © British Journal of General Practice, 2005.