Annex A
A TAXONOMY OF CHOICE
A TAXONOMY OF
CHOICE IN
THE PUBLIC
SERVICES
Who chooses?
Single citizen
Provider/professional
Democratically elected authorities
Democratic collectives
Collectives
Community representatives
A single public sector service provider
A number of outlets within a single public sector
service
A range of public sector service providers
A range of public, voluntary or private sector
providers
A range of public, voluntary or private sector
providers contracted to a public sector body
Choice is exercised by the individual service
user
Choice is exercised by the provider or professional
on behalf of the user
Choice is exercised on behalf of citizens by
democratically elected authorities
Citizens exercise democratic expressions of
preference
Groups of users join together to exercise choice
collectively
Representatives exercise choice on behalf of
communities
Service provision can be obtained by only one
public sector provider, but there may be opportunities for enhanced
choice by offering options to users
Service provision is by one public sector provider,
but the user can choose the service between different outlets
Service provision is from the public sector,
but the user can choose a similar service from different public
sector providers
Users choose their service from the full range
of public, voluntary and private sector providers, paid from public
funds
A number of private and voluntary sector providers
are contracted to a local authority to offer distinct forms of
a service and/or to allow users to choose between different providers
Patients choose a GP
GPs choose appropriate hospital or consultant
on behalf of patients
Local authorities influence priorities and quality
of services provided
Choice over whether council-run stock should
be transferred to registered social landlord resides with tenants
in a ballot.
Residents' associations choose an additional
service from a local authority
Community representatives sit on Local Strategic
Partnerships and help to influence priorities
Refuse collection—Local authorities may
wish to offer the choice of additional collection services such
as garden waste
In secondary health care, from 2005 patients
will be able to express a choice from five hospitals on referral
for elective surgery
Patients decide whether to access a GP, walk-in
centre or NHS direct to meet their particular need
Direct payment schemes in community care allow
users to spend their grant with the provider of their choice
Some social housing choice based lettings schemes
operate in this way: registered social landlords and private landlords
are contracted to the local housing authority to provide social
housing
From whom do they choose?
A taxonomy of choice in the public services
How are they enabled to choose?
Preference
Private funds
Provider charges
Public funds allocations
Mixed funding
Non-financial allocations
Voucher
The provider
How the service is provided
Aspects of the service such as the timing, location
or nature of the service provided
Description Example
A preference can be expressed within the existing
capacity of public sector provision
Users use their own resources to purchase services
outside the public sector
Users use their own resources to choose to purchase
services which are charged by the public sector provider
Where public funding allows users to choose
their provider and funding could vary depending on the needs of
the user
Where public funding may be topped up by private
contributions by the user, possibly depending on the income of
the user
Where users are provided with resources other
than money such as a priority related points allocation
Where users are provided with a sum of public
funds in the form of a voucher to spend on the service provider
of their choice
Choice between different providers of the same
service
Choice between different ways of obtaining the
service they require
Choice in the way services are accessed, for
example to provide more flexibility to suit modern lifestyles
Right to express a preference in regard to secondary
school allocation
Now exercised by some 6.8% of parents nationally
in regard to secondary school
Local authority leisure services
Community care direct payments schemes in which
local authorities make cash payments to individuals to purchase
their own community care
Co-payment health schemes in United States of
America
Points based allocation of social housing 1996
Pre-school education voucher scheme
Patients choose which Primary Care Trust contractor
to register with
Patients choose between seeing their GP, seeking
advice from NHS Direct or attending a walk-in centre
Primary care practices provide evening and week-end
surgeries
What do they choose?
Source: National Audit
Office
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