From hospitals to schools and social care, an independent review by David Boyle concludes we want more choices in public services. David Boyle explains why the UK should move towards a broader kind of choice.
Last year, I was asked by the government to look at choice in public services, and what gets in the way of people making choices.
The chance to choose what hospital we go to, or what school we send our children to and how we use our money for social care… This has all developed over the past ten years with backing from this government and the last.
In the opinion poll we commissioned, 81% said they thought it’s important to have a choice of service. Clearly, people are keen to get a choice, especially when things have gone wrong in the past with the way they were treated. The difficulty is that there has been very little research about whether people were actually using those choices, whether it was difficult for them to do so and what got in the way.
Barriers to choice in public services
For my ‘The Barriers to Choice Review’, I spoke to people the length and breadth of Britain. Although it was clear that people from all backgrounds want a choice in the services they receive – they want a meaningful choice. They want all the information and the advice they need, and the confidence and authority to ask for flexibility in the way services are delivered.
Often the kind of choices we think we’re being offered are not what we’re actually getting.
We may get to choose where an out-patient’s appointment is going to be, or express a preference about where your children should go to school. But my work showed that people want something less neat, and sometimes simpler – like a choice of a consultant who won’t mind you asking them lots of questions. Or to study Spanish at A-level when all that prevents you is the school’s timetabling system. Or to go to bed later than 5 o’clock when your carer comes round.
Unless you’re confident and articulate, bureaucratic barriers can get in the way of making these choices. And if you want something slightly out of the mainstream then there’s inequality in the choices available to everyday people across the UK, because you need confidence to overcome them.
Plus, we all need information and advice on what choices are available to us, yet this often proves problematic. Not everyone has access to the internet and this makes it even harder to find out what choices are available. Others would prefer face-to-face advice.
Giving you more authority
I hope my report helps officials understand that people with the same symptoms or situation might actually want different treatment. People should be given more authority, at least to ask if their specific needs can be accommodated.
We live in a post-assembly line world: not everyone needs to be treated in exactly the same way, just as everyone’s priorities are different. But choice also needs to recognise that we are not just passive recipients of public services. Real choice means we can begin to share responsibility with professionals, for our own care and recovery – and maybe also for the recovery of those around us.
Do my findings fit with your experiences of making choices in public services? Would you like a broader kind of choice?
Which? Conversation provides guest spots to external contributors. This is from David Boyle, the independent reviewer of the government’s Barriers to Choice Review. All opinions expressed here are David’s own, not necessarily those of Which?