More can mean less

For the NHS, 2006 might well be the year of choice. The UK government's plans for “empowering patients to play a bigger role in choosing where and who provides them with their health service” are finally to become reality.1 2 These plans will be supported by the twin pillars of competition, and plurality of provision. To be pro-choice is clearly to be on the side of the angels, or at least the politicians. Spare a thought this Christmas, therefore, for a small group of people who insist there is another side to the argument.

In a recent bestselling business book, psychologist Barry Schwartz argues that the amount of choice on offer in life exceeds our ability to effectively exercise that choice, or even to enjoy it.3 The debilitating effects of choice overload may be bewilderment and high levels of anxiety and stress. When a brush with illness in the United States caused health …