IMAGINE going to your doctor and being told you need an operation.No longer facing a lengthy wait at your nearest hospital, you decide which hospital you want to be treated at and then book your operation time through your digital television.

By Jessica Nicholls

IMAGINE going to your doctor and being told you need an operation.

No longer facing a lengthy wait at your nearest hospital, you decide which hospital you want to be treated at and then book your operation time through your digital television.

Sound like something from Star Trek? Well by the end of next year this could be the way healthcare works.

Never before have patients had so much say and choice about their NHS health care.

But while people are being given the option to go elsewhere if they have been waiting too long, it seems in Ipswich at least, most people are preferring to stay put.

This week Labour and the Conservative parties went head to head with their vision for health - but they both seem to be singing from the same hymn sheet when it comes down to it. Both want to reduce waiting times and both want to offer the patient choice when it comes to their healthcare.

This summer, major changes are already taking place, offering patients the choice of where they are treated if they have been waiting for more than six months.

It started in April with most forms of surgery being available under the choice programme apart from Ear, Nose and Throat surgery and Orthopaedics which are due to be rolled out in the next couple of months.

And while, according to the Norfolk, Suffolk and Cambridgeshire Strategic Health Authority, the programme is going well, most people have opted to stay with their nearest hospital, particularly in Ipswich.

Rebecca Harper is Choice project manager for the SHA. She said: "We have not had an enormous take up of it.

"The reason is that people are very loyal to their local hospitals and that is especially true in Ipswich.

"But those who have taken it up are finding it brilliant."

So do people actually understand what Choice is all about?

Mrs Harper said that at the moment Choice at six months only applies to a certain amount of people who are contacted and have it all explained to them at the time.

However when Choice is rolled out to everyone from the end of next year, giving people the choice right from the beginning of their treatment, Mrs Harper said things may be different.

Which is why the SHA is acting now to do a survey to gather people's views about future development of healthcare.

Questionnaires are going to be posted to a sample of households within Norfolk, Suffolk and Cambridgeshire during the first two weeks of July to find out what information people will need to make their choices, what extra services people want to see in their communities and how people want to see services improved.

Surveys have to be completed by July 16 and there is also an online version available for people to register their views.

Questionnaires will also be available through some voluntary organisations and GP practices.

This week the NHS Confederation said at a conference that they would also like choice rolled out into the community as well as just being used for surgery and to bring down waiting times.

Eventually there will be choice of maternity services and what are known as "end of life services" making sure patients have a say about everything.

Mrs Harper said: "We are going to a lot of effort to make sure people do understand it.

"We need people to let us know how we can help them understand it.

"That is the kind of thing we need people to respond to."

n. Online survey - www.yougov.com/nhsnhcp which will go straight to the survey.

WHO GETS WHAT CHOICE AND WHEN?

With Choice at six months, patients are not actually given too much choice.

If they have been waiting for nearly six months they are given an alternative choice at another hospital, but could still have another three month wait.

All patients however, must be seen within nine months overall.

Most NHS hospitals have waiting lists, so how can adding to lists around the country work?

Mrs Harper said the alternative choice does not necessarily have to be in an NHS hospital. Deals have been done with private hospitals to provide treatment and there are also specialist nurses and GP's in the community who can also provide treatment where appropriate.

The alternative will allow for a booked appointment so the patient can guarantee surgery and should also be for faster treatment than would be possible in the original hospital.

According to the DoH guidelines patients must be treated before they have waited nine months for treatment.

If they are offered treatment in a hospital further away and do not have access to transport then it will be arranged for them.

Choice at referral is due to start by December 2005. This will see them being offered a choice of four or five hospitals once their GP has decided that they need to be referred to a hospital. This is known as the choose and book scheme.

Once patients have chosen where they want to go, they will be able to choose when they have their operation through the national electronic booking programme.

Appointments can be made at the GP surgery, contacting the centre itself, online, and eventually through digital television.

The alternative will allow for a booked appointment so the patient can guarantee surgery and should also be for faster treatment than would be possible in the original hospital.

WHY GIVE PEOPLE CHOICE AT ALL?

In November last year the DoH commissioned a survey by MORI into patient choice.

It found that 76 per cent of patients wanted to be involved in decisions about their treatment, 42 per cent wanted to choose their appointment time and 31 per cent wanted to choose their hospital or doctor.

And in April this year a YouGov poll commissioned by the Economist found that across all social types people wanted more choice in their healthcare.

The poll also found that when offered faster treatment 75 per cent of patients in Manchester and 67 per cent in London took the alternative choice.

Around 50 per cent of patients needing heart surgery have chosen an alternative hospital for faster treatment between July 2002 and June 2003.

Information source - Department of Health - www.dh.gov.uk

PANEL - Health secretary this week vowed to slash hospital waiting times from an average nine months to just weeks within the next four years.

Revealing the Government's vision for the NHS for the future new targets hope to reduce waiting times, halt rising childhood obesity and cut the number of emergency inpatient bed days.

There will be more help for chronic disease sufferers, more illness prevention and an increased NHS capacity.

Smoking is also targeted which aims to reduce adult smoking rates from 26 per cent in 2002 to 21 per cent in 2010.

However the Conservative Party has put forward their own visions - again wanting to offer patient choice and less waiting times, but vowing to scrap all central targets on NHS hospitals including those for waiting lists and the star-rating system.

Shadow health secretary Andrew Lansley said the Conservatives would free health professionals from bureaucracy and give patients and GPs the information they need to make informed choice about hospitals.