Giving Consumers of British Public Services More Choice: What can be Learned from Recent History?

Abstract

British Prime Minister Tony Blair announced in the autumn of 2001 that he wanted to extend individual consumer choice in the public services (Blair, 2001). What do we know from recent experience about the conditions under which such policies can be sustained? In this article, the experience of individual consumer choice over the last ten, and in some cases, fifteen years, is compared across nine fields of British public services. The article identifies the policy goals for introducing choice, considers how far they were typically achieved, and identifies problems and unintended side-effects, including distributional problems, inefficiencies and one type of political risk. This provisional evaluation is based on a widely ranging review of literature spanning several disciplines. The principal products of the argument are two detailed tables, setting out, respectively, the degree to which the goals seem to have been achieved for each choice programme, as far as the available literature can tell us, and how far distributional, efficiency and political risk problems have dogged consumer choice in each field. In the discussion section, trends and variations are summarised. Finally, some lessons are drawn from the comparisons, for policy makers who may be considering the further extension of consumer choice in public services.