Patients and consumers

Successive governments of the UK have strongly supported two policies: an NHS free at the point of delivery, and the encouragement of consumer choice. It was natural for governments to think that amalgamating the policies would increase patient satisfaction, improve efficiency and save money. There are many reasons why this has not been well-received by patients and doctors and has not saved money, but the underlying problem is that there is a conceptual misfit between healthcare as public policy and as individual responsibility. Patients in the NHS cannot become consumers and doctors cannot become suppliers of goods and services.