Surveys of satisfaction with the NHS tend to prompt discussion about reform. Research by Irene Papanicolas, Jonathan Cylus and Peter Smith investigates what determines people’s satisfaction with their health system and why it is oftentimes erratic. International comparisons show that overall satisfaction appears to represent something different in each health system, indicating that there is no panacea for improving satisfaction ratings in all countries. In the UK, they find that GP performance is closely linked to overall opinions of the NHS, and so policies that addresses GP responsibilities might have an important influence on satisfaction levels