Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
John Appleby writes with typical accuracy about the way in which political affiliation affects satisfaction with the NHS. I would take issue only with the first of his two pieces of advice to political parties: that being in power boosts satisfaction amongst your own supporters. The trends in figure 2 show that Conservative voters became less satisfied in all three periods of Conservative government and those during the Labour years. Likewise Liberal voters were less satisfied after their party shared power for a term. The second of Appleby's conclusions therefore must stand as the only wisdom: to satisfy the voters the government must actually deliver benefits.