In among all the hubbub about Ofcom, public service broadcasting and the future of Channel 4, who would have thought that Patient Opinion would get a mention? What a surprise!

And it's true - already we've had some very valuable help from the folks at 4ip, so far focused on getting the basics of the site right - search engine optimisation (Googliness, you might say) and usability. We're learning lots of good stuff which will soon turn itself into a better site.

But being mentioned in the context of public service broadcasting made me ponder. Patient Opinion is a digital publisher, and doesn't aspire to broadcasting. While we like to think we provide a public service, we also provide a service about a public service - the NHS. And, am I'm sure Paul must have said before somewhere in this blog, although we are looking for an audience, we're not looking for one in quite the same way as BBC online or CNN or anyone else.

For each posting on Patient Opinion, we're looking for a narrow, well-defined audience: those particular people - maybe the NHS manager, clincian or patient activist - who can take a story about their local health service and do something practical and positive with it. This isn't public service broadcasting, it's public service improvement. And we love it.

Now that we include mental health services on Patient Opinion, it is interesting to have a look at what postings are coming in and how they might be grouped together.

Let's start off with a look at feedback about psychiatrists.

Here are two postings from individuals who felt listened to:

Thank you to staff at Boston House

Treated very well and received great help at Hollins Park Hospital

and (in the interests of balance) two postings from individuals who didn’t:

Attempting to gain treatment for Mental Illness

New appointment and support needed

Interesting that for service users in these postings (and others you'll see on Patient Opinion), the focus has been on the quality of the listening and the attentiveness of the consultant.

There's been a fairly vigorous reaction to health minister Ben Bradshaw's proposal to allow patients to rate and review their general practitioner on the web.

Reading the blogs and the newspapers, I'd say the vote is probably running 4 to 1 against, with many familiar - and valid - arguments on both sides. Yes, we want more openness, more accountability for apparently aloof professionals. No, we don't want medical decisionmaking to pander to all demands, a site that encourages manipulative behaviour, spurious statistics.

One of the strong themes running through the critical comments - from both doctors and patients - has been a strong resistance to the idea of patients being asked to act as customers. 'We don't want to read or write reviews, nor score our doctors,' say the patients. 'We just want our doctors to be good, and trust them.'

But is asking patients to behave as customers what Ben Bradshaw had in mind when he announced the policy? Well, yes, it seems to be. For example, the Guardian reported:

'I would never think of going on holiday without cross-referencing at least two guide books and using Trip Adviser,' said Bradshaw. 'We need to do something similar for the modern generation in healthcare.'

Fair enough - but, in 2009, isn't this starting to feel a little Web 1.0? Is the 'Choosing what to buy' metaphor the best we can do?

Web 2.0 (this isn't exactly news) offers much more - the chance to move from customer to community, from me to us, from buying something to building something, together. As Ivo Gormley's recent film Us Now makes clear.

Our resolution for 2009 is to find ways to use the web to move from feedback on the web to change in the real world.