Working for patients?.

An examination of the 1989 White Paper, Working for Patients, to decide how far its optimistic forecasts have come true, focussing especially on the problems arising over extra-contractual referrals. Scenes from the 1989 Conservative Party Conference, show how the catchwords of "more choice" and "patients first"f1 were launched into the vocabulary of Government health service policy. Yet, two years later, it seems that patients face increasing restrictions rather that more choice in the matter of when and where they can obtain treatment for non-urgent conditions. Health Minister Stephen Dorrell appeals for more time. But long-suffering and frustrated patients live in a different time-scale from Mr. Dorrrell - one in which a "non-urgent" - condition can make it impossible to carry on a normally active life. Can greater freedom of choice for patients ever be refused with the budgetary realities? Is the government refusing to acknowledge the obvious consequences of its NHS policy?