Philip Booth calls for a bold ramping-up of consumer choice in health provision, arguing that it would benefit both services and the citizen.
recent research  published by the IEA, it was found that opinion-formers in the health policy field were losing confidence in the NHS. This is an extraordinary result, given the strong vested interests that favour continuing with the status quo.
Nevertheless, the work explains how the Labour government has managed to make significant strides towards introducing competition and choice into the supply of health care. But more must be done to ensure that the consumer, and not the bureaucrat, is sovereign.
On balance, the reforms over the last 12 years are welcome, but sometimes one wonders whether the government has privatised the nationalised sector or nationalised the private sector.
Supply-side reforms can be taken further. Individual trusts must be given complete autonomy over terms and conditions of employment. National pay bargaining means that too few staff are prepared to work in high-cost areas such as London. In turn, low-cost areas are paying more for staff than they need to and budgets do not go as far as they should.
But the next big step must be to empower the consumer. Politicians claim that we cannot allow choice in health because of market failure. But in Britain we have such an extreme model of state-controlled healthcare that damage caused by government failure completely outweighs problems of market failure that could arise in a system designed with consumer sovereignty at its heart.
The Conservatives argue that power should be devolved to the professionals to doctors and nurses. This is all well and good: professionals should have responsibility for clinical decisions. But, as far as wider aspects of health provision are concerned, power should belong with the people. It is only through real people exercising real choice with real money that resources will be directed to where they are desired.
It is not possible for politicians and administrators to know whether people want to spend more money and receive care at more convenient times and closer to home, or whether people want cheaper ways of providing care. The same applies with drugs. Given the option, it seems that people want to spend more money on innovative, risky drugs than the NHS allows, but would rather spend less money on branded drugs if cheaper alternatives are available. People should be able to exercise choice.
Also, the UK is renowned for health