Patient Foster went to Gloucester!

Andy Burnham has come up with a good wheeze. Patient choice. That is he wants us all to have the ability to choose the doctor's surgery that we want. So do the Tories, who are keen to tell us they thought of it first. Sounds good in principle but there's bound to be a catch. I can think of three to start with. First, some doctors are just better at the bedside manner than others. Grouchy types may find patients have left en masse. Now that may be an incentive for all to become more patient friendly, but a bedside manner is not the first requirement in patient care.

The second is what happens on referral to consultants. If you've decided to travel 60 miles to see a doctor because that particular doctor is the best you think you know, where will you be referred if you need an operation. And thirdly, for children and those who work away from home the choice is not about one doctor but the chance to register with two, which is not allowed at present.

As with a lot of things it sounds good on first hearing. Chat about it a bit more and you find it's not so simple. I'm reminded of a family holiday to a boarding house in the wilds of western Scotland in the Sixties. A Yorkshireman and his wife were in the same establishment. He had decided he was unhappy with the food on offer - basically what you saw is what you got. One evening he leant over from his table and whispered, knowingly, to my father, "I've been down t'other 'otel 'an they've got menya cards!" Needless to say it caused a stir in the dining room and the proprietress was at a loss as to know why.

I'd suggest that Andy Burnham makes sure his menu cards don't have too much choice on them otherwise we could all get an unhealthy dose of indigestion!