02 June 2006
The government has pressed ahead with an extension to its flagship Patient Choice initiative, despite new evidence from the Department of Health that shows well-educated patients benefit most from the reforms.
Since January 1, patients have been able to choose where they receive their hospital treatment from at least four providers. But from this week patients can also choose to be treated at the 32 existing foundation trusts, health minister Andy Burnham announced.
The list will include the five new foundation trusts announced this week, and will be extended later this year to include 15 independent sector treatment centres.
But the announcement came as research commissioned by the DoH from consultancy Rand Europe, the King's Fund think-tank and City University, London, revealed that Patient Choice risks widening health inequalities.
Understanding patients' choices at the point of referral, published on May 31, surveyed 1,000 people in England who had been referred to hospital over the past five years.
It found patients with formal educational qualifications were more likely to choose a hospital with higher clinical standards. Those without qualifications placed less importance on above-average clinical quality.
Rand Europe senior analyst Peter Burge said: 'This study… raises uncomfortable questions about how best to provide a health service that promotes equal access to the best performing hospitals for those in equal need.'
The report also found that patients were not swayed in their choice of hospital by waiting times of less than ten weeks from GP referral to treatment, and that hospital performance and travelling time were more important than their GP's opinion.
But Burnham insisted patients would be put in control of their own treatment. 'We are at last creating a health service where care is provided to their convenience and not the health provider,' he said.
'We want to see patients increasingly having the right to choose where to go if they need treatment or care – nobody should have to accept a “get what you're given” culture.'
Foundation Trust Network chair Andrew Cash welcomed the extension of choice. 'Foundation trusts will be working hard to ensure these new choices are made available to all patients. This will require a real drive to ensure both patients and GPs have the information they need to make informed decisions,' he added.
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