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Last Updated: Thursday, 13 November 2003, 13:25 GMT
How much choice can you afford?
Choice is a wonderful thing. Everyone agrees about that. But can choice in health and education ever be anything more than a politician's soundbite?

Labour MP Diane Abbott was crucified in the media and by some of her parliamentary colleagues because she chose to send her son to a private school.

She says she only did it because she could not get her first choice of state school.

Although relatively few parents can afford the luxury of going private like Miss Abbott, many will sympathise with her dilemma.

The government may claim greater choice in schools and education - and league tables to judge them by - has led to an improvement in standards. But that has not prevented a scramble for places in the best local state schools each year.

Think again

To get the best educational deal for their offspring, parents become experts in form-filling, arm-twisting, letter-writing and even schmoozing the local vicar (if they hold sway over the local church school).

Diane Abbott
Diane Abbott put her son above her "reputation for consistency"
Many who would not normally dream of sending their children to a private school - either out of principle or because they can't afford it - suddenly find themselves thinking again.

Some will pay thousands of pounds extra to live in an area with better schools. Others have to put up with what they are given by the local authority - or else end up in a tribunal battle.

The number of school admission appeals has gone up by a third since Labour came to power, reaching 63,611 in 2001. The percentage of successful appeals has remained steady at 32%.

That means more than 40,000 families had to put up with second best for their children's education in 2001.

Dramatic flight

Little wonder, perhaps, that the number of people opting for private education has been steadily increasing.

Over the past 30 years, the number of pupils in private schools in England has increased from 523,800 to 580,300 - from 6.12% of the school population to 7.09%.

The flight from the public sector is even more dramatic in health, largely because of employment-related medical insurance schemes. In 2002, 6.7 million people were covered by private medical insurance in the UK, about 11% of the population.

That compares to 5.5 million people in 1985, and 2.3 million people in 1975, according to analysts Lang Buissom.

Here four people talk of the choices they have been faced with in health and education - and how they dealt with them.

The myth of 'choice'

Journalist Andrew Neather says he could probably afford to send his two daughters to private schools.

But the former Number 10 speechwriter, who worked on Labour's 1997 general election campaign, said he wants them to be educated by the state.

The problem, Mr Neather says, is that the local state primary schools where he lives are suffering from underinvestment and their results are "dire". Either that or they are church schools.

The only option, he believes, will be to move house to an area with better schools.

"The way I feel now, I can not envisage a situation where I would send my children to a private school. "I would be willing to make huge sacrifices to send my kids to a good state school."

He says his desire to send his children to a state school is "not just a question of abstract political principles".

"I went to a very large comprehensive, then I went on to Cambridge. I think I had a more rounded experience of life than people who went to public schools.

"At the same time, I want my kids to do well and to get good results. You need that. You need both - and getting both is not easy."

State education - at a price

Marketing manager Roddy Langley wanted to send his daughter, Poppy to a private school but could not afford it.

Instead Mr Langley and his wife Kate, a dance teacher, moved from central London to Dulwich Village, in south London, to be near a good state primary school.

Mr Langley says he went to public school and wanted his child to have the same start in life.

The couple believe they paid a 50,000 premium to be in an area with good state schools. But by sending Poppy to the local village primary, they calculate they save that amount in school fees.

His only concern is that the state sector will not provide the same standard of education - potentially jeopardising Poppy's chances of gaining entry to a public school later.

He believes the "basic reason" why most people decide to go private, is because of the social problems associated with some state schools.

The thought of his daughter being anywhere near the violence and drugs of the average inner-city school is "absolutely abhorrent".

"There is a time and a place for her to become streetwise," he adds.

Medical emergency

As a self-employed blacksmith Edward Wood, 68, from East Anglia, had always paid his national insurance contributions.

He had also paid into a private medical insurance scheme.

But when he was struck down by a rare nervous system disorder, he was let down by both the state and private sector.

He was told his medical insurance didn't stretch to the expensive course of treatment he needed.

The treatment was available on the NHS - but he was told he would have to wait two years for it.

The only option, Mr Wood says, was to pay for it through another private medical company.

"If you are not getting what you have paid in for under the NHS, you have no option.

"If you are in constant pain there is nothing else you can do.

"It's a shame, but I don't know what else I could do."

The only problem is that he has had to continue working beyond retirement age to cover the bills.

The NHS health tourist

Kent pensioner Margaret Lucas waited 15 months in agony for a knee operation.

Going private was not an option, as she could not afford it on her army widow's pension.

But last year she became one of a small, but growing band of NHS patients to be treated abroad.

She travelled to a hospital in Lille, France, for her operation - and has since been back to have a hip replacement.

She finds it "sad" that she was unable to find treatment in the UK.

She is also acutely aware that others may not be as fortunate as her.

She says a friend who had been due to travel to France for a hip operation has just been told that it will not happen until the Spring, as there is not enough cash left in the health authority budget.

"It was sad that I had to have the treatment in France. But the hospital was absolutely excellent.

"I would definitely recommend it to anyone, if they have the opportunity."

Add your comments on this story, using the form below.

My experiences of NHS hospitals were humiliating and dire. I don't like the idea of a two-tier system but now that I have private health insurance, I feel that I owe it to myself to use it.
Catherine O, UK

We have three children and did not expect to educate any of them privately, but Matty has dyslexia, dyspraxia and also concentration difficulties. Despite this we were advised that he would get no extra help at our local High School. We are now paying for him to attend private school (partly funded by remortgaging our house), where for the first year he was in a set of nine children with extra help. Despite being in the bottom set of three he came third out of the whole year group (more 40 children) in his physics exam. He is now in year eight, is confident and loves school (unlike when he was at the local primary school). Although we personally do not approve of private education, we felt it unfair to sacrifice his future for our principles. I sympathise completely with Diane Abbott.
Dawn Beck, UK

This Spring I was diagnosed with cancer. I didn't want choice I wanted to be treated. I had two excellent operations at my local hospital where I received excellent care. This is the experience of thousands of people getting great care from the NHS. What do the media focus on? Not the big picture but these individual cases.
George Davidson, Slough, UK

As a parent I cannot criticise Diane Abbott's decision, but as the product of a working class family who was fortunate enough to get a grammar school education (something denied to my children) I am disheartened that children from families with limited income will not get the chance I did. My children are not yet at school age and I am actively considering all the options open to me to ensure they get a decent education.
Lyndon, Wales

My wife had an ear complaint. She could not take the lack of hearing any longer (being a teacher), and could not wait for the NHS. So she is going mixed NHS and private to monitor the condition. Funny, though, it is the same consultant she sees in both cases, except he seems to cancel his NHS surgeries more frequently than the private ones.
Simon, UK

I am firmly of the opinion that those who CAN afford to pay for private education should do so and help to free up resources for those who are less well off. The same goes for health issues - if you can afford it, have it. This will again help to bring down waiting lists. I'm sick of hearing people complain about poor education, waiting lists on the NHS etc but they still run two cars, have two foreign holidays a year and their homes are bursting with all the latest mod cons. Some of us haven't seen a dentist for two years because we can't get registered with an NHS one & we can't afford to go private.
Kiltie, UK

It's usually implied that private education is better than state education and I'm sure in many case that may be true. I had the opposite experience in that I left a private school due to large class sizes and exceptionally poor teaching and went one of the local comprehensives, which was regarded a very average school for the area. I went on to do A-levels, a degree and a PhD... Sometimes you don't always get what you pay for...
Anna, UK

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