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Choice is an alien concept to patients

We are public servants and it is entirely appropriate that the Government should decide on the electorate's behalf what we should do - however daft its ideas are.

Choice is not really what people want. What they want is for their local hospital to provide a good and timely service. There will always be a few of the worried well who will check the internet and agonise over which service provides the best hernia repair and travel 50 miles to the hospital of their choice.

But the patients in our patch - especially the elderly - would no more think of travelling 15 miles to another hospital than of travelling to the moon.

Unfortunately our local trust has not always provided a timely service in many specialities, and its managers don't seem to realise that if they don't invest in good quality rapid services, patients will vote with their feet and take their business - and the resource that comes with it - elsewhere. What a way to run a service.

From Dr Arnold Zermansky, Leeds

The addition of choice into the GP contract is just another time-consuming exercise that does not benefit patients in any way. It is certainly not on their wishlist. And in any case, patients already have choice, so why make it mandatory?

Some PCTs have introduced a local enhanced service to encourage GPs to offer choice, with GPs having to get a form signed by patients to show they have done it. We discussed this in my area but the view of the PCT was that patients are being offered choice already but don't always remember when surveyed.

My view is we have a clinical responsibility towards the patient and in a 10-minute consultation there are better things to do than this political exercise, which is not based on any evidence.

From Dr Krishna Chaturvedi, Southend, Essex

Just 46% of patients recalled being offered choice, but how many actually wanted it and for how many was no choice available? How can GPs be expected to guide patients on services provided by hospitals outside their area?

It would be difficult to prove a patient was denied choice, although it would help if the survey results were broken down by PCT.

I am led to believe we, in the Wirral, are very high users of Choose and Book. Don't tar us all with the same brush.

From Allan Stewart, practice manager, Wirral

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