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● If you had to select one word that symbolises the ideology that supposedly drives the modern approach to social care you might well choose "choice".

"Extending greater choice to service users is at the heart of current government policy," say ministers. We're surrounded by it. Better Information, More Choice is a Healthcare Commission service user consultation document the adult services green paper is called Independence, Well-being and Choice: Our Vision for the Future of Social Care for Adults in England.

Clearly, having choice is better than having no choice (or accepting whatever you're given) but could we be at risk of being spoilt for choice? I remember my first experience of real choice. The London polytechnic where I studied social work in the early 1980s had an exchange programme with the State University of New York. So, I went across the pond for a semester.

A small banana in the Big Apple, I went to a deli bar to get a ham and cheese sandwich. In England I would have been given exactly what I asked for: a slice of ham and some sweaty cheese stuck in between two slices of bread. I'd thank them kindly and go on my way.

Not so in America. There I was asked what type of cheese I'd like: Dutch, Swiss or American? I didn't know. Dutch? No, Swiss. Not American. Do Americans do cheese? Then I was asked if I wanted American, smoked, honey-baked or Southern ham? What no Dutch? I didn't want any of them - I just wanted plain old ham thanks. And then came the bread. Would I like white, brown, rye or wholegrain? More blank looks. I just wanted a freakin' ham and cheese sandwich!

In the end I left with a bag of crisps, despite having asked for chips. I had even been beaten by our shared choice of language!

➔ E-mail your anecdotes and observations to rosie.warlock@yahoo.co.uk