I really think one of the biggest problems with the NHS these days is that the general public abuse the service, and that this is because as a society we no longer remember what things were like before it existed. It's taken for granted that clinicians are at our beck and call now, and all the targets and patients' charters reinforce this view. I'm not suggesting that people should be charged the real cost of a night visit from a GP, or a 999 ambulance call (I'm not naive enough to think it's that easy), but if they were, I'm sure there would be less abuse of the system. I absolutely agree that one of the best ways we could save the NHS money would be to educate the public in how to use the system responsibly. Regarding GPs, I used to be a doctor's receptionist and I think the problem with them is that they are independent contractors to the NHS, not employees. Thus their main priority is making money, not patient care (although admittedly, 'patient care' is their main method of making money, but only in a roundabout way). My experience is that they won't take part in any initiatives unless they are paid to do so (directly or indirectly), however much it would benefit the patient, and only use 'patient care' or 'patient confidentiality' as a front to hide behind when it looks like they will end up either losing money, or getting sued. See for example all the recent publicity over the Choose and Book service - surely a benefit to patients - but from a GP's point of view, making a booking at the point of referral means more time taken per patient appointment = less patients seen = less money; or alternatively it means more administration = more staff required = less money. PS you must be sick of hearing it, but thanks for the great blog, and deepest respect to all paramedics and EMTs, keep up the good work.