Describes the development of a multi-item scale for assessing in-patient perceptions of service quality in an NHS or NHS Trust hospital. Presents evidence of the high reliability of the scale and its factor structure. Five intangible factors emerge: empathy, relationship of mutual respect, dignity, understanding of illness and religious needs, along with two tangible factors: food and physical environment. Results in a trial hospital indicate that patients' perceptions meet or exceed expectations in respect of four of the seven factors and 22 of the 49 individual variables. Of concern, however, while possibly not generalizable, must be the unfulfilled expectations in respect of the factors "relationship of mutual respect" and "understanding of illness" and the individual variables relating to the various communications between doctors and patients. Not unexpectedly, dissatisfaction is also expressed with the physical environment. Argues that the situation can only be remedied, usually, by a large injection of cash--an unlikely scenario.