Fallacy or Functionality: Law and Policy of Patient Treatment Choice in the NHS

Abstract

It has been claimed that beneath the government rhetoric of patient choice, no real choice exists either in law or in National Health Service (NHS) policy (Whiteman in Health Care Anal 21:146-170, 2013). Thus, choice is considered to be a fallacy in that patients are not able to demand specific treatment, but are only able to express preferences amongst the available options. This article argues that, rather than considering choice only in terms of patient autonomy or consumer rights, choice ought to be seen as serving other functions: Choice serves as a mechanism of destabilisation, i.e., as a lever for change. This is apparent at the level of patient and doctor, and at the level of patient and health authority, but even more so, at the level of government. Patient choice, rather than benefiting the individual, can have effects on a wider scale. It encourages change and reform in healthcare practices and in the NHS institutions.

Keywords: Destabilisation; Fallacy; Functionality; National Health Service (NHS); Patient choice.