Most GPs are boycotting the government's scheme to give patients a choice of at least four hospitals for diagnosis and treatment on the NHS, a survey of patients revealed yesterday.
The Mori survey of 270,000 patients who had a first outpatient appointment in May or June showed only 30% could remember being given any opportunity to choose the hospital. The health minister Lord Warner said the results were "not good enough". Officials are still uncertain whether GPs have subverted the scheme by not telling patients about their rights or whether they are putting so little emphasis on the opportunities that patients forget what was said.
The survey showed 70% of patients in some parts of England remembered being given a choice, but in other areas the proportion was less than 10%.
Patient choice was Tony Blair's big idea for reforming the NHS by putting hospitals under competitive pressure. Since May the options have been extended to include foundation hospitals anywhere in England. In 2008 the choice will be widened to include any private or NHS hospital which can meet government standards on quality and cost.
The scheme depends on GPs - the "gatekeepers" regulating access to hospitals - telling patients about their rights. They were given a small financial incentive for using the Choose and Book electronic appointment system. But the Mori survey showed 70% of patients getting an outpatient appointment between May 22 and June 4 at one of the biggest 160 hospitals in England could not remember being given a choice when they were asked a week later. Only 20% of those who could remember being offered a choice were provided with a leaflet explaining the options.
Lord Warner said: "In 14 primary care trusts, at least 60% of patients were offered a choice by their GP for their first hospital appointment. These PCTs prove that choice can work."
But in Hastings and St Leonards, East Sussex, Bradford, and Southend-on-Sea, Essex, less than 10% got a choice. A further survey in July showed a small improvement, but the provisional results remained disappointing.
Lord Warner responded by launching trials of a scheme to make choice booklets available in public libraries. Richard Vautrey, a negotiator for the British Medical Association's GPs committee said: "The experience of most family doctors is that patients are choosing to go to their local hospital when they are referred, and most refuse the Choosing Your Hospital booklet." Many patients may have forgotten being offered a choice, he added.
Stephen O'Brien, a Conservative health spokesman, said the government's offer of choice was designed to secure favourable media coverage. "But the necessary steps to infiltrate it into the reality of the experience of patients are not taken," he said.
