URGENT action is needed if the Government is to give patients more choice of where and when they get hospital consultations, says a report.
The National Audit Office looked at progress towards the Health Department's promise of offering every patient referred by a GP for non-emergency treatment the choice of four or five hospitals by December.
It found a tiny fraction of referrals had so far been made through the new e-booking service set up to deliver patient choice.
It also found that many GPs were against the principle and nearly a third of hospitals had no plans to implement the scheme.
GPs' reluctance and non-compliance of IT systems in surgeries and hospitals with the £196m central e-booking system - along with an intermittent technical fault - have been blamed for hampering progress.
The report said that out of 9.4m non-emergency referrals up to December last year, just 63 were booked through the NHS's new Choose And Book computerised system, rather than the hoped-for 205,000.
And the system will only be operational across 60% to 70% of the NHS by December, the report added.
While acknowledging that some progress had been made, the report
found that nearly a third of primary care trusts have no plans to introduce any patient choice, while more than a quarter say they will not achieve the December target.
A survey of 1,500 GPs found that half of them knew very little about patient choice. Just 6% were well versed on it.