By Eleanor Bradford BBC Scotland health correspondent

Patients will have more hospital choice in England than Scotland

English patients will soon be offered a choice of four or five hospitals while people in Scotland will be referred to the most appropriate local hospital.

Some health experts believe the English system will result in bigger improvements through competition.

But many GPs say the systems are not in place in England to provide such a choice of hospitals.

Under a system called "choose and book", English GPs should be able to offer patients to offer them a choice of at least four hospitals or clinics in which to be treated.

Dr George Ray is originally from Fife but went to a GP practice in Whitley Bay in the north of England 25 years ago.

I don't think there is any doubt that there is a benefit in offering choice Dr George Ray GP in England

"This is the most radical change since the inception of the NHS in 1948," he said.

"I don't think there is any doubt that there is a benefit in offering choice. There have been occasions where I have wanted to refer a patient to the Leeds area in the past that has proven very difficult."

In Scotland, the emphasis is on collaboration, with doctors being told to work more closely together to shorten waiting times and improve the treatment on offer at patients' nearest hospitals.

Dr Andrew Buist is a GP in Blairgowrie, in Perth and Kinross.

'Different here'

"We are able to offer our local hospitals," he said. "It's different up here because the population is not as large and there are not as many local hospitals around.

"If you are up in Highland you only have one hospital for several hundred miles, so we are limited to the local choice that we have."

Scotland goes arguably against the natural instinct for people to be competitive John Deffenbaugh

John Deffenbaugh works with health managers implementing change. He lives in Scotland, but frequently works in England.

He said England was characterised by "choice, competition and market" whereas words used to describe Scotland were "collaboration, co-operation and partnership".

He said: "There is a dynamism in England that comes from a lot of competition from people wanting to do well, beat the targets and achieve the targets.

"In contrast, in Scotland the drive is very much around 'lets all work together, pull together on this' which sometimes goes arguably against the natural instinct for people to be competitive."

Dr Ray added: "What many of my patients would want is to be seen locally in an acceptable timescale and to have quality delivery of service."