An excellent paragraph or two in a paper from the NHS Confederation, “Alive and clicking: information that benefits all“:
“In the lexicon of public policy there are two ways to improve public services: exit and voice. Exit enables people to choose a provider so they can leave services they do not like. In NHS terms, it is about choice, markets and the Any Qualified Provider policy. By contrast, voice is about getting involved and trying to change and improve services for yourself and your family. For NHS users, voice is about taking action such as complaining or becoming a member of a foundation trust or patient group, writing to the chief executive or even suing the organisation.
“Over the last 30 years, exit, markets and choice have largely ruled the roost while voice has been a whisper at the policy table. However, the costs of structuring markets are static or rising. Meanwhile, the costs of having a voice are falling like a stone.
“Successful providers will get much better at motivating and engaging their local populations, albeit through more people commenting about them, getting angry with them, making suggestions, and thanking their staff. Some of this will be on generic platforms like Facebook and blogs, and some will be on platforms dedicated to making feedback easy to use for busy staff like Patient Opinion and NHS Choices. These conversations will very likely play back into choice and the market because what consumers learn from their friends and other users of similar services is a powerful predictor of behaviour.”
arbitrary constant 