"There was fifty-seven channels and nothin' on" - Bruce Springsteen

CHOICE is the buzz word at the moment. I wish it would buzz off, but it looks as if we are stuck with choice.

As Tony Blair and Michael Howard prepare the ground for the General Election, choice is the word that leaps off their lips whenever there is a television camera around.

Before we get to the latest example of this distressing outbreak, which concerns the National Health Service, it is worth considering the broader topic.

It could be said that selection is the modern curse. Rampant variety multiplies our options. Mr Springsteen makes the point in the quotation at the top of this week's column, although he is perhaps out of date. Many more channels are available nowadays, even if some of us still make do with the five.

However many channels there are, Bruce is still spot on. One of the paradoxes of modern life is that more so often means less. Where the United States led the way in pointless broadcasting choice, we are following, thanks to digital and satellite TV.

Yet sit down to watch something in the evening, and all these assorted channels do no not guarantee better viewing. Quantity is all and quality gets trampled in the rush to provide more.

Choice assails us wherever we go. In the supermarkets, we are faced with bewildering possibility, free to buy whatever we want from groaning shelves which are constantly replenished. If we have the funds, it can be pleasant to shop like this, although, like watching too many television channels, it can lead to headaches.

In a strange way, choice is also alienating. The more choice we have, the less likely we are to enjoy the shared experience - unless it's wandering around the supermarket aisles in a mass daze, wondering what to buy.

England's brief run of success in Euro 2004 provided a fleeting antidote to choice. Everyone who was interested, and even a few who weren't, wanted England to win. If this turned out to be a foolish desire, it was a communal urge. For a few nights, most people were engaged in the same activity and wanting the same outcome.

Choice is so often sold to us as a force for good, usually in the sense of providing competition. Yet choice can be negative. Having to make decisions can be stressful, because you have to weigh one option against another.

So when Tony Blair flourishes before our tired eyes a "personalised public service" in which we will be able to choose where and when we want to be treated, we should be happy, shouldn't we?

Well, yes. Then again, choice can cause stress. So if an unwell person is waiting for an operation, they will not necessarily be comforted by having the pick or four or five hospitals. They will want to be treated properly and well at the nearest hospital.

Michael Howard also believes in choice. I read what Michael had to say; I read what Tony had to say; and I felt strangely down-hearted. If choice is going to be the battleground, I suppose we will have to choose between them.

For my National Insurance contribution, I'd say it was outrageous for Mr Howard to suggest the Tories would spend £1 billion on subsiding patients going private. If people opt out of the NHS, why should they have access to public money to smooth their treatment?

But if that strikes me as plain wrong, nothing Tony Blair is saying offers much in the way of solid encouragement.

With such choice around, patients are going to have to take on much of the responsibility for their own health care. They will be expected to research the available care and will have to acquire a good understanding of the system. All that after they have spent hours on the internet investigating their disease or complaint, and in the process flooding their poor minds with too much information.

By the way, you could read this column on newsprint or on the Internet. Or you could decide not to read it at all. You choose.

Updated: 10:54 Thursday, July 01, 2004