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Last Updated: Sunday, 28 January 2007, 12:56 GMT
Choose and book
Surgeons
Will the public get critical choices right..?
Once upon a time in the NHS "doctor knew best".

But 60 years on, we are customers not patients and the government want us to have more of a say in when and where we are treated.

The idea is that if patients have control - then the market that they create through choice will drive up standards and save money.

It is called "choose and book" and the government wants us all to use it.

Heavily funded

The choose and book initiative is part of an NHS IT system which is costing 12bn over the next 10 years.

The idea is that patients can either choose their initial hospital appointment while they are at the surgery or they get given a unique patient ID and pin number which allows them to go away, research the hospitals and then book on the phone or via the internet at a time that is more convenient to them.

It should cut down on the number of handwritten referral letters which take longer and can get lost in the post, allow people more control over when and where they are treated.

Nurses at nursing station
What will Choose and book do for hospital administration?

And, by rolling out nationally, it should give choice to everybody - people in less affluent neighbourhoods as well as to the wealthy.

In theory, you could choose the hospital with the best clinical reputation, the shortest waiting list, or the best record on hospital-acquired infections.

But, there are complaints that it is very hard to find out this sort of information, and most people simply choose the hospital nearest them.

At present, a patient should have at least four choices of hospital, but by the summer that should be up to 200.

The Department of Health target is for 90% of all patient referrals to be made using the system by March, but currently it is about 35% and critics complain that the system is not working as it is supposed to.

There are two particular complaints:

Many doctors can not now refer a patient to a specific consultant, just a hospital team; and GPs do not always have the time, and patients can not always get extra help, to guide them through the choose and book process.

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