At the moment, if you need outpatient hospital treatment for example to have a mole removed or an ulcer treated you go to your GP, who sends a letter to the hospital he or she chooses for you, and the hospital advises you of the timing of your appointment.

You then trundle off to the hospital, which may or may not be easy for you to get to, on a date which may or may not be convenient.

But now, patients are about to be given a greater say in their treatment under what is being billed as patient choice'.

From January 1, patients will be able to select from four hospitals (or other centres) to have their treatment. And, from April, a fifth option approved foundation and private hospitals will be added to the list.

Additionally, through an electronic system called choose and book', also expected to be introduced in April, patients will be able to select the date and time of their appointment from their GP's surgery, through the national NHS Direct web site, or via the internet.

The benefits to the patient are obvious greater control over their treatment but the medical profession says advantages are also tangible for them.

A spokesman for Barnet Primary Care Trust (PCT), which looks after the delivery of community health services in the borough and manages GPs, said: "The choice, including the private option, will help to drive up overall quality across the system, and it should result in better tracking of a patient's progress."

Additionally, he says, the number of patients not attending their hospital appointment will reduce because they themselves have chosen it to suit them Barnet and Chase Farm Hospitals NHS Trust estimates that 14 per cent of its patients are no-shows.

Peter Packer, chairman of the Barnet PCT's patient forum, said: "Overall, patients should welcome it, providing they get the proper backup and advice from the GP surgery. The patient takes control of everything and it empowers them."

But some query the value in giving patients choice, when other factors, such as quality, should be at the forefront of developments.

Alex Nunes, chairman of the Barnet and Chase Farm Hospitals Patient and Public Involvement Forum (PPIF), said: "Anything which gives the patient some control has to be a good thing, but we have to remember that the patient isn't an expert. People tend to be driven by emotion rather than common sense when they are ill.

"Our general feeling is that patients like the idea of choice, but really, with a national health service, you should be aiming for the very best possible care wherever people are," he said, although he added that he believes standards would be pushed up as a result.

Mr Packer agreed patient choice should go a long way to driving up standards, "But it may increase financial headaches for trusts that are underperforming, because people will vote with their feet," he said.

A case in point, he continued, would be Barnet and Chase Farm hospitals, which are currently proposing to transfer all emergency care to Barnet and all elective surgery to Chase Farm in The Ridgeway, Enfield.

A trust spokeswoman said she hoped Barnet and Chase Farm hospitals would be the hospitals of choice' for people.

"What affects the choice patients make is complex," she explained.

"The journey to hospital might be one factor, but so are past experiences of the hospital and its services, and reputation."

Dr Albert Manning, of the Hendon and Edgware branch of the British Medical Association, is concerned that patient choice is the gateway to competition and, ultimately, privatisation.

"It puts hospitals in competition with each other and that can destabilise the situation and existence of our hospital trusts," he explained.

From April, NHS funding for hospitals will be known as payment by results' hospitals will be paid a tariff for the procedures they do. Currently, hospitals are contracted to do a certain number of procedures at the start of the financial year, but they may perform more or less than this number.

Dr Manning explained that good' hospitals will attract more patients and get a higher income. He worries that some hospitals, particularly those in the private sector, will cherry-pick' the procedures which will makes them the most money, and that other hospitals would lose beds and services due to a lack of income.

The Royal Free Hospital in Hampstead already has a £10 million deficit, while Barnet and Chase Farm Hospitals NHS Trust says it will be £6.6m in the red by the end of March.

However, the trust believes it will gain under the new financial system to the tune of at least £5m for 2006-7.

Conversely, instead of reducing their waiting times, hospitals which build up good' reputations could find themselves oversubscribed.

The Royal Free has also acknowledged the need to attract patients to maintain services.

"As money follows patients, we will have to attract patients in order to maintain services," said a spokeswoman.

"If we succeed, then we will be able to maintain and, in some cases, expand our services. However if we fail, then we will have to reduce them."

But Mr Packer admitted that patients don't always run to the private sector. "Convenience and access is one factor," he said, "and to some people there is a familiarity about their local hospital."

Mr Nunes agreed, saying it is unlikely that patients will want to travel far.

And that is what the hospitals themselves may be hoping.