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Lets just take a slight reality check here. It's really, to my mind, pretty over-simplistic to say the NHS is built around the needs of the staff. If we start constantly from that point we're tilting at windmills.

Our services are, however, often built around a series of more pragmatic and practical limitations and constraints. Availability of staff with the right clinical skills; the need for critical clinical mass; the value of Team working; the need for appropraite infrstructure to support care; the hard fact that this can't be available everywhere many patients might like it 24/7.

You could equally argue some service industries are built around the needs of their staff because I can't pop in to my local bank or Kwikfit 24/7, 365 days a year.

But that doesn't negate the pressing need for greater patient involvement in decision-making, whether in their own care or dveloping/assessing service generally. And we need to be better, franker and more transparent about those discussions. What doesn't help is starting those discussions from limited generalisations.