After a sprint that I would classify as Olympian, I made it.  The doors were making their final beep-beep, the guard (god-bless-him), held his door and bundled me and my bag onto the train. It was packed.   Phew! St Christopher was looking down on me.

I was off to spend the day with a group of super clever, very switched-on, interesting, sassy, up-for-it, knowledgeable specialist nurses that practice their art in the under spoken sector of Stoma.

Expecting to make the most of my 90+mins on the train I fished out the iPad to make a dent in my emails. No wifi, intermittent 3G signal. Hopeless. And, it was getting cold. Over an hour of insidious cold air, bone chilling, marrow freezing. Cuppa-builder's to cheer myself up? Yer 'avin a larf. No trolley.

If someone with a tick-box, clip-board had approached me at Peterborough Station and said; 'how was it for you'... I'd have said stuff it, miserable; next time I'm in the car.

Would that be fair? The train left and arrived on time. I got what I paid for. The guard outperformed by hauling me onto the train but it was a cattle-class experience and I nearly froze to death. Which box would I tick? Satisfied or hacked-off? Guess!

Satisfaction is a difficult thing to measure.  Every year the people at the British Social Attitudes survey have a go.  Asking; are you satisfied with the NHS. Their latest attempt took place last year; before the present hiatus in A&E, before primary care started to melt, before ambulances we stuck in a traffic jam in hospital car parks and social services hit the buffers.

The survey tells us people who used the NHS were more satisfied than any time going back to the 1990s. Even people with no first-hand experience of the NHS thought they were satisfied; probably something to do with the Lansley-Redisorganisation slipping out of the headlines.

Labour supporter satisfaction went up by 11%; probably explained by 'satisfaction' being wrapped up in thoughts of 'support', at a time when the NHS was facing some difficulties and financial pressures.

There is a siren-signal for GPs; satisfaction has been slipping since 2009 and is now ski-sloped to 71%.

This survey is about peoples' views and not about NHS performance. It is not what we think now; it is an old Polaroid not an oil painting. We know the NHS remains the top public priority for government spending; hence the interminable squabble amongst the political classes; who runs the NHS best. Both sides of the debate will seize the survey and 'weaponise it'.

Andy Burnham went first and published Labour's part wish-list, part reorganisation health manifesto. Paying for it will depend on a precarious two year haul through regulation and Parliament, passing laws to be able to tax people in big houses.

More doctors, more nurses, more mental health, more of the usual and more gaps in how to pay for it. Dumping the TDA into Monitor and emasculating the result as Burnham plans to scrap Alan Milburn's market. Crunching health and social care together with the thinly disguised intention of handing the keys to the front door of the NHS to local government.

The Tories are yet to join in. Whatever they promise, history tells us don't trust them. Look what happened last time.

After a week of politicking and polling are we any the wiser? I think not. Labour has a vested interest in telling us the NHS is terrible. The public say it is not. The Tories have a vested interest in telling us the NHS is OK. Plainly it is not.

If NHS managers wrote a manifesto what would it say?

1. Simplify and resign urgent and OOH care,
2. Get real about safe staffing levels,
3. Determinedly coordinate care home, primary and community care,
4. Subsume aspects of social care into health,
5. Develop a cohesive workforce strategy,
6. Provide a sensible doable, deliverable, achievable, feasible, workable plan on funding,
7. Create a huge push on mental health services,
8. Return to a population based, capitated payment basis, in return for an eye-watering focus on operational best practice and the delivery of constitution standards, paid for by...
9. Dumping Tory embroidery of Labour's patchwork of ideas; Monitor who are supposed to produce a tariff and failed (a huge vote of no-confidence in David Bennet), the vacuous TDA who promised FTs and failed and the CQC who for 15 years, in various iterations, have promised safer services and failed.

My guess; that would get a tick on the clip-board and a cross on the ballot paper.

Have a good weekend. 

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'What is the point of a select committee' come and join me in conversation with Dr Sarah Wollaston MP, chair of the Health Select Committee.

 Kings Fund 11th March - details here. 

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roy.lilley@nhsmanagers.net 

Know something I don't - email me in confidence.

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