'Build it and they will come' or will they? Choice, policy paradoxes and the case of NHS treatment centres

At a time when 'choice' is being proposed as the main driver for cultural change and the raising of standards across the public services generally, this article examines some of the policy issues involved with reference to one particular organisational innovation being implemented within the 'choice' agenda: National Health Service treatment centres. In this context, the article reveals eight policy paradoxes across five dimensions (market, cultural, systems, structural and political) that remain unresolved. We suggest that our findings may have broader implications across other public sector services that are implementing similar policies aimed at maximising consumer choice.