Leading article: A healthy start in the search for a cure

A long-standing defect of the NHS is that it has given patients far too little say over their own treatment. So the expansion of patient choice announced yesterday comes as a welcome, if long overdue, first step.

From April, patients will be able to choose to be treated at any hospital in England. This should help tackle the hospital postcode lottery. It should also offer improved services for patients, especially for those with rare conditions which are often treated better at regional or national centres of excellence.

Individual patients have shown a desire to use new powers of choice already given to them, seeking treatment at smaller community hospitals and more specialised treatment centres. It is a sign that the Government's internal market reforms are beginning to have some effect on the behemoth that is the NHS.

We have few illusions about the degree of resistance that the expansion of choice is likely to encounter. Some doctors will argue that greater patient choice injects an unwelcome element of rivalry into the NHS, setting hospital against hospital, and lowering morale. But an injection of rivalry is just what is needed to ease the long-running inefficiencies that have plagued the NHS's performance in recent times, and force it to become more patient-focused.

Others may object that they just want a good local hospital. But the best way to push up standards generally is by giving patients the opportunity to opt for the best-performing hospitals, highlighting the worst and forcing them to improve. Could it be that the Government has learnt from what happened in 2000, when it failed to ensure that its record levels of NHS investment were accompanied by reforms to boost efficiency and reduce mis-management?

Increased choice is a good first step in giving patients greater control over their own treatment, but reform must not stop there. Offering patients a choice of hospital is fine, but that choice is worth nothing unless they are also armed with the information to make an informed decision. The publication of primary trust performance ratings is a good start, but more is needed. Patients should not need to conduct hours of research into the best centres for their condition, or remain reliant on their GPs for good advice. The Government must also ensure that, when poor-performing hospitals are highlighted, they are given help to improve.

And while the introduction of greater choice should be welcomed as good in itself, this reform must not be allowed to stop there. It should provide the springboard for the evolution of a new NHS – one that puts patients back where they belong, as the reason why the service is there.