"Please grade this Hospital/Practice well in the questionnaire, or we will lose funding and your services will get worse!"

That will be what happens in reality so who is going to do that?

All these bigger clinics will suffer from MRSA, C.Difficile infections - bring back smaller local doctors

Sam Redman, London, UK

How can fining and under-performing hospital possibly be in the patients interest ? Sack those who are not doing their jobs properly , don't punish the patients further .

Benzo, Nr Chelmsford,

Care plans have existed for 30 years plus it's a shame there are not enough nurses to actually implement them. Plenty of administrators plenty of jobs worths. The main problem is lack of nurses junior doctors and too many paper targets to acheive-filling in all the lenghly paper work reduces pt care

Chris, Coventry,

Until Fitness to Practice is made safer and actually helps both parties,nothing will change!complain even if you have previously had no reason to and despite 5th report, you will be treated like a criminal rather than a legitimate complainee worried about your children being frightened or made ill.

mary foord brown, suffolk coastal,

What is it with this inept bunch or morons of a government.

This is certainly not going to improve moral or efficiency by fining or granting bonuses. For starters get rid of some of the overpaid administrators and consultants. Ask the nurses and front line staff what they want and need.

Alec, West London,

Consulting patients about the NHS? Does anyone seriously believe this Government will take any notice? They haven't in the past so why would they change the habit of a lifetime and start now.

Fred James, Worcester, UK

Responsible medicine could suffer here. Many things leave patients feeling unhappy; much of the time it is justified- imagine the scenario when a doctor refuses to give antibiotics for a viral infection- surely he would now be financially inclined to give the patient what he wants against evidence?

Tom, London, UK

Darzi is a tertiary surgeon who is out of his depth in healthcare policy planning. He should go back to the day job.

By all means privatise part of healthcare - the part based on WANTS, and keep the part based on clinical NEED under the NHS, but please be honest about it.

Dylan Murphy, Lerwick, Scotland

Tomtom, Speaking as a medic- it is certainly not our duty to ration healthy budgets. Perhaps there is an argument that we should, but at the moment our duty is to practice responsible medicine- and if this means spending money then so be it (if it means saving money then so also be it)

Nick, London, UK

Brilliant. Now what must be done is to apply it to our politicians and especially Mc Broon

bob holmes, Axbridge, England

Can they not stop tinkering around with things endlessly and at least allow a bit of time for the last raft of reforms to settle in before they mess with things again? It's the same with education. No wonder morale is so low.

Bev, Bucks, UK

I don't mind paying MPs on the basis of consumer satisfaction but not doctors. They are gatekeepers designed to ration health budgets not to fund every whim and every hypochondriac in sight.

For a Government which rations funds to healthcare and diverts spending to PFI .....

TomTom, Leeds, England

Standard NuLab tactic:
If it ain't broke, break it, measure how broken, burden the freshly broken with new rules and overhead to prevent improvement, find new unbroken area, repeat.

Can the next election come fast enough to save the NHS?
I have my doubts...

Mike, Tauranga, New Zealand

"24 hours to save the NHS" were the words of Teflon Tony.
Can we fine New Labour for providing "poor care".Oh I forgot they're skint. Incidently they appear delussional and are obviously a danger to themselves - perhaps we should have them sectioned under the Mental Health Act.

W George, Leeds, UK

So if I goto my doctor and want antibiotics for the flu and he dont give them to me - he's got to cos now I is da boss not him.

Winston MacLennan, Harehills, Leeds, UK

The way to put the NHS back on it’s feet, is to save money by only treating the indigenous population free of charge, any immigrant and that must mean anyone not born in the UK or from a country that does not have agreement care scheme with Britain, should have to have paid at least five years national insurance contributions before being eligible for free treatment.

gordon, plancoet, france

Care plans sound like a good idea, but chronically ill people should be being cared for properly anyway. Any written document means extra staff, writing, reading, filing, the possibility of un-correctable errors and so forth. I suspect that the Government's interest lies in data collection.

Ann, Midlands, UK

We already have a legal right to chose our GP's, we already have a right to treatment overseas.

Ann, Midlands, UK

We would not have a problem with over priced drugs if someone investigated and regulated the pricing of new drugs. Drug companies routinely over charge the NHS for drugs which were developed years ago as it is. They go unchallenged, no other market force would get away with this.

Ann, Midlands, UK

This sounds bad coz then people would be able to demand whatever they want and drs are forced to comply so that they don't get fined. dont' think 5y med school is needed with the new system...

sw, cambridge, uk

What a joke. The whole problem with the NHS is that people now expect to receive what they WANT rather treatment based on clinical need. If the NHS is to be sustainable, we need to move away from personal desire to evidence based treatment. As a surgeon, Darzi should know this.

Colin, Stirling, UK

The mentally ill will find their treatment delayed because they miss apointments. Good doctors will be overburdened and so will see their work quility reduce. Patients will ignore the experts and choose ineffective trial drugs and alternative therapies, wasting millions of pounds.

Stupid Brown.

Tim, Edinburgh, Scotland

This sounds like a load of rubbish. I am just fed up with the endless list of pointless reforms being dumped on the NHS.The government just seem to be wasting taxpayers money on pointless,costly reforms that bring no real benefits to the public. Maybe we could get rid of Mr Brown for being unpopular?

F Benfield, Rochester, England

you can imagine what the questionnaire will be like- about 3 hours to fill, with the most negative outcome being something like partially satisfied.
the hospitals should be sold, every person should have private medical insurance, then the hospitals have to compete with each other.

will, grimsby, uk

"we expect that to filter down" bet it don't.

Phil Barnes, preston, england

I wonder what difference this will make for flagship Mental Health services?

Andy Capp, Herts, England

Oh dear - I see hospitals filled with less doctors and nurses - and more co-ordinators, public satisfaction liaision officers, statisticians, public service managers and the like !!!

Richard Garland, Manchester,

Lord High Every thing else may wish to consider that if I give the wrong answers on a questionaire he will cut funding and hence the level of care that the EHS provides locally. His Polyclinics are designed for people with cars who need occassional vists after work. Who voted him in?

Dave Burns, London, England

And as usual, the NHS will be able to fudge and fiddle figures and opinions to their own benefit, so there will be absolutely no increase in services, it will cost us more, we'll end up getting less and the NHS bureaucrats well get paid more. Smoke and mirrors.

Paul Downes, Milton Keynes, UK

Great idea. Let's take money away from the hospitals that really need it and give it to the ones that don't! Thank God I have private medical insurance...

Rich, Surrey,

which insane person came up with the idea of fining or rewarding hositals?the NHS needs as much as it needs, not a penny more, not a penny less

peter c, Devizes, Wessex

I'm confused; how is this a consitution if it can be changed by a simple vote in the house? Shouldn't a real consitution require a 2/3 majority to change it, or something similar?

Cronan, London, UK

Oh this sounds like a winner. So when the script drug addict does not get his fix because he is an addict & Doc acts responsibly not giving it to him cut the funding to the hospital. If people are unhappy because they had to wait 5 minutes punish the hospital. Sir Humprey Appleby is in charge of NHS

Jason Pearson, Toronto, Canada