On 2013 Oct 24, Felix Greaves commented:

In their commentary, Seddon and Lee suggest that patients in England “get what they are given”, while making an argument that the National Health Service fails to extract the benefits of a competitive market. In fact, competition and choice have increased substantially in the NHS under reforms undertaken since 2004, with patients now able to choose their hospital for provision of secondary care for almost all conditions. The latest national choice survey found that 49% of patients recall being offered a choice of hospital for their first outpatient appointment (1). The impact of these reforms on health care quality is contested (2). What is known is that despite choice being available, the English public infrequently choose to go further than their local hospital (3). Even in hospitals with high profile quality failings, elective care attendances are resistant to change (4). Seddon and Lee may expect a rational market for health care, but despite being offered a choice of hospital, the English public does not behave as if there is one.

1) Report on the National Patient Choice Survey - February 2010 England. London: Department of Health; 2010.

2) Pollock A, Macfarlane A, Kirkwood G, Majeed FA, Greener I, Morelli C, et al. No evidence that patient choice in the NHS saves lives. Lancet. 2011. 378(9809):2057-60

3) Dixon A, Robertson R, Appleby J, Burge P, Devlin N, Magee H. Patient choice: How Patients choose and how providers respond. London: King’s Fund; 2010.

4) Laverty AA, Smith PC, Pape UJ, Mears A, Wachter RM, Millett C. High-profile investigations into hospital safety problems in England did not prompt patients to switch providers. Heal. Aff. 2012 ;31(3):593–601.

On 2013 Oct 24, Felix Greaves commented:

In their commentary, Seddon and Lee suggest that patients in England “get what they are given”, while making an argument that the National Health Service fails to extract the benefits of a competitive market. In fact, competition and choice have increased substantially in the NHS under reforms undertaken since 2004, with patients now able to choose their hospital for provision of secondary care for almost all conditions. The latest national choice survey found that 49% of patients recall being offered a choice of hospital for their first outpatient appointment (1). The impact of these reforms on health care quality is contested (2). What is known is that despite choice being available, the English public infrequently choose to go further than their local hospital (3). Even in hospitals with high profile quality failings, elective care attendances are resistant to change (4). Seddon and Lee may expect a rational market for health care, but despite being offered a choice of hospital, the English public does not behave as if there is one.

1) Report on the National Patient Choice Survey - February 2010 England. London: Department of Health; 2010.

2) Pollock A, Macfarlane A, Kirkwood G, Majeed FA, Greener I, Morelli C, et al. No evidence that patient choice in the NHS saves lives. Lancet. 2011. 378(9809):2057-60

3) Dixon A, Robertson R, Appleby J, Burge P, Devlin N, Magee H. Patient choice: How Patients choose and how providers respond. London: King’s Fund; 2010.

4) Laverty AA, Smith PC, Pape UJ, Mears A, Wachter RM, Millett C. High-profile investigations into hospital safety problems in England did not prompt patients to switch providers. Heal. Aff. 2012 ;31(3):593–601.