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The claim for patient choice and equity
  1. D A Barr1,
  2. L Fenton2,
  3. D Blane1
  1. 1
    Glasgow Royal Infirmary, Glasgow, UK
  2. 2
    Royal Alexandra Hospital, Paisley, UK
  1. Dr David Adam Barr, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK; davidadambarr{at}


Recently, commentators close to and within the UK government have claimed that patient choice can increase equity in the context of the National Health Service. This article critically examines the basis for this claim through analysis of recent speeches and publications authored by secretaries of state for health and their policy advisers. It is concluded that this claim has not developed prospectively from an analysis of the causes of healthcare inequity, or even with a consistent normative definition of equity. The limited justification that is “framed in causal explanations” of inequity has suffered from an apparent disregard of the available evidence.

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  • Competing interests: None declared.

  • All authors are writing on behalf of the International Health Advocacy Group.