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The case describes the findings of a survey conducted to determine: (a) the attitude of patients to the ''service'' given by an outpatients department; and (b) the efficiency in terms of time with which people were ''processed'' through the outpatients systems. The case can be used to discuss: (a) the problem of objective setting in a non-profit making organisation; (b) the conflicts of interest between medical staff, hospital administrators and patients; (c) the effectiveness of survey techniques for establishing data on system performance; and (d) the broader scale issues of objective setting and managerial problems in a health service system.