Does Choice Deliver? Public Satisfaction with the Health Service

In this article we examine how much the public say they want choice in the provision of public services, and how far their perceptions of the amount of choice they feel they should and do have are related to satisfaction with public services. Our findings cast critical light on some of the claims made by both opponents and advocates of choice about the value the public place on choice. The claim of opponents that the public do not want choice is not supported. Citizens say they want choice and the more they say they want it the less satisfied they are with the service they receive. However, the claim that citizens value choice for its own sake is also not supported. Public perceptions of how much choice people have over which hospital they attend are not associated with higher satisfaction with NHS hospital services once we take into account perceptions of how much patients are involved in their treatment and their views respected. Satisfaction with hospital services is more likely to be delivered by ensuring that patents are fully appraised of their treatment options than by providing patients with choice between different service providers