Whose choice is it?

Our leaders keep banging on and on about patient choice, parent choice, citizens choice. But who are they talking to? No one that I know. I live in a pseudo rural community in the country outskirts of a large county town. Our nearest Cities are either 35 or 50 miles away with no more major town in between. So realistically what is my hospital choice? I am lucky in that my local hospital can provide good general care. Obviously no doctors surgery is based in my pseudo village and where ever I look I am faced with getting the family member into a car to go to a surgery. Whether into town with all its traffic congestion or out along rural roads for a longer but quicker journey. The point is sheer practicalities govern my options. Not value judgements on the skills, published merit points or consumer friendliness of this compared to that surgery.

The scenario is very similar when considering which state school. My town has a choice of three schools all within its suburbia, one to the west, one to the north and one to the north east. Rush hour traffic becomes stagnant around school openings times so to cross town you have to double or even triple your journey time. If you were masochistic inclined you could have a choice to make. Common sense says no one can rely on their job being there tomorrow. We are in very insecure economic times when any jobs, even the most secure, can suddenly evaporate. Any sensible rural based parent will have a contingency plan incase the de rigueur second car has to go. So where do the school bus run take your village kids. This is the real choice, practicalities. Not league tables, not the smarm quotient of the staff, certainly not that it is governed by well meaning but ruthlessly ambitious middle class parents, not the newness of its buildings or even whether it has been bestowed academy status. Just the simple day to day exigencies how do I manage to get all my kids to school day in day out, all weathers.

I am lucky I am one of those middle class parents or patients. In my days we ran two cars, at enormous cost, so I could commute and my wife could do the chauffeuring as and when required. The point is this is a very middle class privilege. I do not believe the majority of the country enjoy the economic freedoms of running two cars and being able to exercise a degree of choice. They, the countries majority, are totally dependant on the norm state provision. There is no option or choice their kids go to where the school bus takes them. They go to the only practice that will accept them within their neighbourhood. Their income and expenditure is tightly contained by what the grey faces deem reasonable. They do not get to do choice. Other faceless one choose for them and only sanction the costs they deem permissible. So where is the demand for choice coming from?

Set aside London and a few of our bigger cities and I suspect the largest percentage of our population will empathise with my situation outlined. The government policy makers, the originators of the think tank outpourings are all London based and all doing very well thank you. They are so out of touch with the economic realities and have a totally distorted view of travel options when deciding for us we need more choice. In London with a wealth of travel options, with alternate schools, surgeries or hospitals in all compass directions and all within a short easy journey time. Choice may well be a sensible driving force. May, but I doubt actually. All it does is give the economically mobile more freedom whilst at the same time severely limiting the provision for those without the economic freedom to choose. So what might be a consideration for London is not a sensible, desirable or attainable option for the vast majority. What is needed is not choice but an excellent universal provision, available to all regardless of income, background or vocal clamour.