If you think RLH is bad, wait til you see Newham General. I have to say, from my experience (apologies to Tom and NHS colleagues in advance) the place needs pulling down. The wards were filthy. Absolutley filthy. Under the beds had never seem a mop at all and the walls were splattered with blood and other bodily fluids. The people were ok, but clearly overworked and undermotivated. It was clearly a shame, but they had no idea how to deal with my illness (they had already sent me home twice to take paracetamol before I called the ambulance). I was so glad when they admitted defeat and transfered me to a far cleaner hospital in North London. It's a real shame that this happens, and that a management structure can get so far out of control that situations like this occur, but it's a fact that there is a marked difference in the performance of organisations with essentially the same goal. As consumers, sorry patients, we hold the purse strings. And I know exactly where I choose to spend my taxes.