If you asked a hundred random employees in the NHS what they thought that the NHS needed, I suspect few of them would suggest yet another managerial reorganization. But that is just what we are in the thoes of. Our hospital managers are hell bent on us applying for "Foundation Status"; from their point of view it will no doubt be an opportunity for new job titles and pay rises. From the Department of Health's point of view it is a great opportunity to devolve problems ("not our fault, the're an independent foundation"). From the point of view of us poor foot soldiers the benefits are far from clear.
One of the hoops that they have to go though is to prove that they have local support and to sign up 4000 locals as "Foundation Trust Members". This is a bit tricky, so the way that our managers have done this is to announce that all employees (even if, as in the case of my clinical assistant you only work for the hospital three hours a week) are automatically deemed to be in favour of the applcation and to be "members". If you want to opt out of this you have to give the management your name and details of where in the hospital you work - which few are hardly likely to do when only a few months ago one in seven of the hospital's employees were on redundancy warnings. No such thing as a secret ballot.
So there you have the new democracy: you're automatically in favour, whether you vote for Foundation Trust status or now, unless you give then your name and put your head on the chopping block. Even the Iraqis had something closer to a democratic election.