The government expenditure in public services has been tremendous and many patients felt that they were more accessible and responsive when things went wrong. However, what has been lacking in most such situations is the management aspect. …
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Former UK Prime Minister Tony Blair also sought to improve this particular area through implementation of choice in public services, which served purpose in a limited sense. However, choice has not been necessarily preferred by the customers more than quality of service. In a limited sense, it has improved services sector, and also brought about some competition for existing players, but equity aspect can still be debated. For the purpose of this discussion, we shall also specifically consider health sector and discuss various aspects related to availability of user choice therein.
When Tony Blair's government assumed power, it was noticed that public services were slowly crumbling with tremendous dissatisfaction to customers. The fact was true across the spectrum, whether health services, education or any other field. Lack of competition, lesser choice to customers and pathetic outlook of service providers towards users led to hapless customers waiting for long periods for the service, and then returned home dissatisfied. Queues were getting longer, wait for elective surgeries went up to 12 months and there was evidently tremendous wastage of resources. The system was unresponsive to patient's genuine requirements; giving a feeling of being organised more to favour those who worked within it rather than those who used it. Lack of equity was evident with most services favouring well off people and mostly at the cost of services to poor. (Le Grand, 2006).
In fact, in a survey by MORI on words that described state of public services in Britain today, the adjectives in descending number were bureaucratic, infuriating, faceless, hardworking (the only positive note), unresponsive and unaccountable while friendly, efficient, honest and open were among the lowest ranked. (Le Grand, 2006)
This led to an action by the government in the form of offering choices to a customer regarding service provider, rewards directly linked to quality and quantity of service provided, improving management effectiveness, and other such customer friendly measures. The efficacy of the system as it developed in the form of choice to customers shall be discussed in subsequent paragraphs. There was a feeling of legacy that the government takes more, controls more, but does not deliver more. To overcome these obstacles, reform programs needed to be guided by plurality of provision, decentralisation, and user choice. (Philip, 2006)
The Case for User Choice. User choice is believed to promote better quality, faster response, increased efficiency and equity in public services across the spectrum. It has been described to be more effective than alternatives such as voice mechanism, i.e. speaking up against unfair treatment of customer. While it may not be always the appropriate one, it is an important public service reform. Certain aspects favouring user choice in public services are based on the fact that the user wants more choice today, choice improves quality, responsiveness, competence, promotes equity and facilitates personalisation of services. However, there are certain inevitable
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