ABSTRACT
Essential to genuine choice is the precise idea expressed in economics that is, that by expressing costed preferences, financially empothe authorsred individuals can test out specific adaptations against competition. So, too, the art of beachcombing or the observation upon which choice depends. Or, as Oscar Wilde's Lord Illingworth says in A Woman of No Importance, 'Discontent is the beginning of the success of a nation.' The authors need to consider too the effect of choices, and those instruments which achieve the precis of the economist and the sensibility of the patient. There is a powerful moral and a practical case for health policies based on the principle of liberty and free choice which is fully empowered financially. And the authors should create a system where there is effective consumer demand, by contrast to the present position within the NHS, in which service users have virtually no choices that matter.
