ABSTRACT
The 'choice' agenda engages us all in 'the problem of knowledge', or of how we can know what other people want and how anyone in advance can know what we want or are likely to want and be prepared to pay for. ‘Choice’ is now being given many tasks. It is, as we have seen, the only way to gather knowledge of what services people want and will pay for – either by taxes or by other payments. 'Choice' is democratic and encourages self-responsibility. A genuine ‘choice agenda’ can prompt much more patient control. Clients need to have access to services within days or weeks. They deserve to have a choice of services. However, it is precisely economic power and consumer pressure and thus effective choice which can make a reality of people being able to successfully negotiate continuing and coordinated care.
