Consumerism in the NHS and other public services

Consumerism and choice in public services have been in the media this week.

On Wednesday David Walker in Guardian Society attacked "the Tesco model" in public services. Essentially his argument was that:

The very basis of social policy is assessment of need, followed by distributive decisions that give relatively more to one group than another.

And, therefore, unlike shopping. (Isn't social policy about more than need assessment and distributive decisions - shouldn't it be about empowerment?)

Then on Thursday BBC4's Analysis programme explored how ideas and expectations of choice are affecting everything from personal relationships to public services. It was a more balanced survey than David Walker's polemic. (The second half of the programme on Listen Again focuses on education and health.)

One of the academics suggested that market forces of choice and competition in public services eventually dissolves the state.

I would ask - is this a problem? As long as the state facilitates, funds and regulates provision - does it matter if its not the provider?

What is important is that the state develops the role of society with social enterprises and mutual organisations like co-ops - so that we are more than individualistic consumers.