Academics show costs of choice

Patient choice may actually increase NHS costs, academics have warned.

A report by the London School of Hygiene and Tropical Medicine (LSHTM), hich reviewed all past literature on choice in the NHS, found it can improve services, because even a small number of patient defections 'will signal that there may be problems in the way in which services are being provided'.

But because offering choice requires spare capacity, it can actually increase costs. And 'there have been no studies... attempting to compare the marginal costs with the marginal benefits', the report says.

However, it also says fears that choice may worsen health inequalities are unfounded.

'All socio-economic groups appeared to want to be able to choose, at least in theory,' they wrote. Patients who have chosen their hospital are more likely to describe it as 'good' or 'excellent'.

The report is part of the Health Reform Evaluation Programme (HREP), under which LSHTM will evaluate all the government's policies to reform the NHS. The programme will report in 2010.

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