/ Health, Parenting

Is the government right to open up public services?

Would you like more choice about your healthcare and schools? The government wants to open up our public services – but we must make sure that these choices are meaningful ones.

While so much airtime last week taken up with tales of ambient pasties and the fear of a potential fuel crisis, you could be forgiven for missing the government’s update on its plans to open up public services.

This is planned to ensure that public services, like schools and hospitals, work better for everyone.

What is an open public service?

We all engage with a range of public services in our daily lives – from refuse collection to hospitals, street-lighting to secondary schools.

The Open Public Services agenda is described by the government as a move towards treating people more ‘like grown-ups’ – giving us more choice and control over the services we use and better information to help us choose between them.

The communities we live in should also have a much stronger voice – rather than being limited too much by central or local government.

Rather than just getting what we’re given, it’s an opportunity for users of public services (i.e. all of us!) to ask for what we want. For example, in social care some people already receive direct payments to buy the care services that suit them best, rather than having them arranged by the local council. It’s an idea that has caught on in health too – with personal health budgets being piloted this year.

Demanding more from public services

The argument is that services will provide a better standard of service and be more productive if they focus on what users need. Competition for our custom between a wide range of providers will ensure that we get more choice and that services react better to meet those needs.

In practice, the government is working on a number of ideas to make this a reality. For example, pilots will be taking place this year on allowing people more choice over their GP, rather than being tied to one near where they live.

The government has also pledged to look at tools that might give us more power to demand the services we want. For example, they are looking at a possible new ‘right to choose’ and a campaign to let us all know what our rights are around choice.

At Which?, we want to see high quality public services available for all – so we welcome realistic steps to make services more responsive to people’s needs by putting more choice and control in their hands. But that choice must be real and meaningful and information made available a way that works for people.

What happens when things go wrong?

The government imagines that eventually it will become more of a guarantor of services than a provider – making sure that people have fair access and that basic quality standards are met. They are also looking at how to make sure that people get redress when their choice isn’t met or services don’t meet those standards. We want to see effective mechanisms to deal with people’s problems and complaints when things go wrong.

As I work on health – an area where we’ve been promised more choice for some years – I’m keen to know what your experience is of using rights like this. Have you been supported to make choices about where you receive your treatment, for example? If you didn’t get what you wanted, what would have helped you? And is choice something you even consider when you’re thinking about your health?

Ken Grahame says:
7 April 2012

It’s perfectly simple – the Tories intend to do everything the can to achieve the standard Tory line – ie, break up as many public services as they can. Their promises to keep the NHS “safe” are now seen for the total lies they always were, and by the time they finish, they will have wrecked our Education system as well.
These SERVICES should NOT be farmed out to private enterprise -they are far too important to us all to be used as a source of profit.

Gerald says:
19 January 2013

Which world are you living in, since when does the people who can afford to pay choose the Public Sector schools to educate their children, do you really think they would pay for an inferior system.
People come from all over the World to buy these services surely that should make one realise just how good our Private Sector is..
The state would still be in charge and any safeguards can be built into the purchasing system and if the system is run by properly and efficiently and with non politically motivate Public servants we would have a good chance of getting a good service at a reasonable price which is NOT the case today. STOP being politically motivated and go for the best at a realistic price.


Totally and completely agree. The Tory agenda is to privatise everything and allow the rich Tory Chummies to profit from the move. Just as it was in the 1930s The poor and vulnerable truly suffer – not the middle class or rich.

The only bright spot is the present “government” is so truly inept that it may not survive until 2015 – because the Lib-dem support will desert in hoards if their ratings plummet as many hope..

Sophie Gilbert says:
8 April 2012

I have to add my voice to Ken’s and Richard’s. NO to privatisation of public services, by stealth or otherwise!!!


This break up and privatisation of the NHS started back in the 1980’s with the advent of Trust hospitals. The old medical school tie network were loosing money under the old system of payment for patients because the population of London had moved out to the suburbs and home counties. This meant that the District General Hospitals were getting more money. So to stop this Trust hospitals were invented with the London Hospital Whitechapel being the first.

The London Hospital Whitechapel secured the biggest PFI despite the resignation of Sir Nigel Crisp on the Monday and the £1.4 billion PFI being announced on the Tuesday. Why invest in a hospitals in the centre of London when the demographics show that the busiest hospitals are in the suburbs? Unfortunately it is rumoured that the doctors who made this decision at the London are members of the conservative party. Its strange how under Darzi all the the Trauma Hospitals are old Medical schools in London, poorly accessable and have to have helicopters to meet there own guidelines.

Now we have Foundation Trusts and re-organisation with cut backs. The most vunerable people in our society like the Elderly and the mentally ill have been given the biggest cutbacks.

Involving the Private sector in any delivery of Public Service will end up costing us all more money. The Private sector only gets involved if it can make a profit for itself and its share holders that increases year on year. None of the de-nationalised have inproved the service that we recieve, it just costs us more for them.

Instead of privatising why not look at improving the management of the organisations and involve the workforce, not just a select number of doctors who look after there own interests.

PJ says:
9 April 2012

It seems the Tories and Liberals are out to destroy the NHS, the NHS is the “jewel” of the British way of life, we the public pay for it via our taxes. Understand it needs more control, and don’t let the services offered by NHS be abused by non EU patients. Take example of what privatisation has done to the Energy market, Railways, etc, all these industries are ripping off the British public. Let’s hope the Which group campaign for better energy prices takes off!

PeterW says:
9 April 2012

“Choice” – even if it is not a disguised approach to destroying the public sector – is not necessarily a good thing. Too much choice can be both wasteful of resources and a source of stress for consumers. For example are we really better off having to choose between umpteen gas and electricity providers, each with a myriad of (deliberately) confusing tariff options? I much preferred the old system of simply getting electricity from the electricity board and gas from the gas board, with no decisions to take. Even if the old system did not provide the cheapest possible prices, it arguably gave us an overall quality of life benefit by freeing up time spent on “choice”.

It is horrifying that we may now have to spend more and more time doing research (which the average person is unqualified to do) in order to try and pick the best provider of important services like health care.

Choice does not guarantee a high standard of service. For example, much care provision for the elderly has long been in the private sector, with individuals and their families being free to choose which care home to use. All well and good? No, just look at the scandals regarding abuse and other failings that have made the news.

In an ideal world choice for basic services would not be necessary, if a decent quality of service was guaranteed by one’s single local provider (backed by appropriate quality checks made by the government and with an appropriate avenue for any complaints via an ombudsman).


It’s basic economics that the more suppliers of a product or service independent of each other they realise customers can up sticks and take their money elsewhere if they’re not happy. With monopolies or oligoplies it’s like it or lump it.

“Too much choice is wasteful of resources” you feel… I’m not with you – whose resources?

As to the confusing tarriffs, just go to MoneySavingExpert.com or look at the Which? Switch campaign!

I review my utilities at least once a year and switch if I can find a better deal.

“Choice does not guarantee a high standard of service.”

It sharpens a company bosses mind when customers choose to exodus from their rubbish service. The result is poor firms fail and better ones do well.

It’s your right as a consumer to tell a firm where to get off by not giving them your money.

Bureaucrats only know how to spend YOUR money, and because it’s someone else’s cash and not thier own, they don’t give a whit about the price – they’re not concerned with getting a good deal – why should they? It’s not their money!

Gerald says:
31 January 2014

Dear Peter,
If we lived in the ideal world I would agree with you, we obviously do not, you quote the case of bad Care Homes ,you do not quote that the represent a very small minority, you also dot not mention the recent revelation of really bad Hospitals and all the cover ups perpertrated by fellow public Officials for years, this is something CQC would deifinately not have condoned for the private sector.
For a true comparison check out real facts based on real costs to the tax payee with real quality surveys, then you might arrive at a true situation which the British Public have done for years now, thats the real reason that the private sector exists at all, isn’t it?


It’s high time the public should choose between govt insurer or independent insurers. The NHS has an effective monopoly.

Gerald says:
10 December 2012

The problem is that a large proportion of the Public haven’t a clue what to do with “Choice” just look at the voting system and the pathetic turn out. How much more important can it get for Joe Blogs to respond?? Why do Dictatorships evolve around the World if the masses really wanted choice !
This is what society gets when it allows so called “Public Servants” to rule their lives, Freedom of Choice has been hard earned is this Country use it wisely don’t let it disappear.


Can the NHS really get any worse than it is now? I like the idea of having more choice available for some services.


Surely the acronym NHS means a National Health Service, what is wrong with that being a monopoly?

Surely the point should be that if the NHS isn’t providing a proper service then the people in charge should be forced by the government to improve it? Selling it off to the highest tory donor is NOT an efficiency saving, it actually costs us more.

Also think of the water companies, this was privatised yet monopolies created. They broke up the railways monopoly and now taxpayers are actually paying more whilst private companies take dividends. Yet monopolies still exist on almost all routes.

Stop kidding yourselves that you have a choice, you don’t, you are just being led to believe that you have and that choice creates a better service, when clearly it doesn’t, using the examples of rising rail fares, hosepipe bans and NHS trusts to back up that claim.