What market-based patient choice can’t do for the NHS: The theory and evidence of how choice works in health care

Professor Marianna Fotaki | March 26, 2014 | Analyses


This analysis looks at how the concept of patient choice has worked in the NHS in recent years. It finds that the type of patient choice that contemporary health policy draws on almost exclusively is based on a flawed account of what choices actually mean for patients. Such conception of choice rests on the simplistic and erroneous assumption that appealing to patients’ self-interest will make them behave as consumers in a market place. For choice to work, policy design needs to recognise patients’ multiple needs and their bonds as community members, addressing them as socially embedded individuals. Users’ prior experiences, including their experience of health services, and how the reality of being ill might affect their health-related decisions, need to be accounted for.

What market-based patient choice can’t do for the NHS: The theory and evidence of how choice works in health care

About the author

Professor Marianna Fotaki

Professor Marianna Fotaki

Marianna is Professor of Business Ethics, Warwick Business School, University of Warwick. She holds degrees in medicine, health policy and planning and a doctorate from London School of Economics and Political Science. Before joining academia Marianna has worked as a medical doctor for Médecins du Monde and Médecins sans Frontiers in Turkey Iraq and Albania and as the EU resident senior adviser to the governments of Russia, Georgia and Armenia for ten years in total.See all posts by Professor Marianna Fotaki