Another vague "customer knows best" plan?

So it's finished. After a painstaking twelve months of work and after collating the views of around sixty thousand patients and staff, Lord Ara Darzi has finally pronounced on his review of the NHS. I well remember in early September last year going to the London Beach Golf and Country Club in Tenterden to join a luncheon hosted by Lord Darzi and David Nicholson, Chief Executive of the NHS. The small but select audience were treated to a few opening comments about the review. It promised to be exhaustive; to be brave. It promised to be innovative and not to be sidetracked. So?

It's the patient, stupid. Their views will affect funding, their death rates will be published, their choice of drugs and treatments will be respected, and their GPs will be funded differently to make it easy for them to change practices.

But how many times have we heard this? The GPs I've spoken to since taking responsibility for Kent Adult Social Services have all told me how heartily fed up they are with bright idea after bright idea; with reorganisations on average every five years, and never enough time allowed to bed down changes before the next bright idea comes along.

Some ideas - like personal care plans or access to personal budgets for those with long-term conditions - are things which social services departments have been doing for some time now. Others - like the option to travel to Europe for treatment in UK waiting lists are too long - rely on the patient being able to travel, and the preferred country having the right medical team, the right pharmaceuticals, and hospital or clinic capacity.

Judge for yourself. But I'd rather have seen some real blue-sky thinking building on the dedication of the hundreds of thousands of dedicated staff in the system already, rather than another vague "customer knows best" plan.