You said: "I write about things here in the hopes that someone will read it, about the crap targets, the time-wasting calls, the poor state of our ambulances and all the other things that stop me from doing the job that I'd like to do." I think this is what you should do, but in a more focused way. If you actually want to have an effect, then how about producing a document, a manifesto, or list of suggestions? You could cover different topics explaining the current problems, illustrating them with present or previous stories from the blog, and suggesting practical solutions. Then you have something, that you can take to people in government, or the health service, or other people who might be able to influence policy, and try and make a difference. Also bear in mind things from the administrators angle - they will like solutions to problems but they also have restrictions or targets that they have to meet. You could start constructing the document topic by topic, with one or more blog posts on each topic, get feedback from commenters to help shape the document and make it effective. Once you've done that, the media might be interested in what happens to you and your suggestions...?