Re: If you were the creator of VOY, what would you have done different
If I'd been in charge, there would have been a number of recurring crewmembers, not just characters who appear a few times and are otherwise ignored - how many times did this ship of about one hundred fifty, give or take, that was stranded thousands of light years away from home pull out a crewman we'd never seen before or would see again?
Likewise, I wouldn't have killed the whole medical staff - maybe just the highest ranking members, leaving a few just-graduated nurses who would need the Doctor's experience. It just made no sense that the Doctor, hologram or not, was able to treat the whole crew all the time, mostly on his own. And the ship's best pilot would NOT be the medical assistant - in instances where they'd need the nurse, they'd also need their best pilot at the helm.
I was never annoyed by Neelix, but after the third season, where Voyager left the area of space he knew, I probably would have had him be killed off during the Borg/8472 thing and kept Kes - it would give Kes a story with some meat, having to deal with losing her first love while one of those who represent the Borg, Seven, is one the ship. And I think that Kes would have made a better teacher of humanity to Seven than the Doctor - the Doctor had Seven take up his interests, rather than try to find her some of her own.
Also, there would be some character developments - maybe the odd promotion, especially for Harry - no one should be an Ensign for seven years, but on top of that obscenity, he's a member of the senior staff? By the end of the series, he should have been a full Lieutenant, and at the early half, there should be some resentment among the crew, even if it's just the Maquis crewmen, that this barely-graduated ensign is a member of the senior staff over someone who's more experienced.
The ship would take damage and be dirty - lights wouldn't always work, and the uniforms would start getting ratty and tattered. Although the odd alien species may have adequate repair facilities, most of the maintenance of the ship would have to be done by the crew on a scale of what's important - replacing the lights would be a lower priority than, say, sealing a hull breach with something beyond a force field. They'd have to develop a hydroponics bay that didn't look like it was little more than a garage - feeding the ship would take more than just replicator rations.
At some point, due to this more put-upon Voyager, I would expect there to be a growing feeling among the crew of 'why are we putting ourselves through all of this?' and they'd want to just settle some planet at some point. This would be a major dilemma for Janeway - she was always so determined to get her crew home, but now, her crew would rather find a world and live there. It'd be interesting to see how she'd go through that.
There would be more coupling among the crew - apart from Tom and B'Elanna, it seemed like the whole damn ship went celebate (excluding the main cast when the script called for it). That's not realistic. And it would lead to a few more kids among the crew - Voyager becoming a multi-generational ship would present further incentive for the above 'settle down' plot - I'm sure many of the crew who were reproducing would rather their children be safer on a planet somewhere than flying through space in a ship that is being held together with the 24th century equivilant of duct tape and chewing gum.
I'd be more focused on doing things on the ship and with the crew than creating some outside problem for them to deal with - due to the situation, I'd expect there to be a great deal of character conflict, despite Gene's previous dictate about how humans have evolved past such behavior - it goes back to what Quark says on DS9.
They're a wonderful, friendly people – as long as their bellies are full and their holosuites are working. But take away their creature comforts... deprive them of food, sleep, sonic showers... put their lives in jeopardy over an extended period of time... and those same friendly, intelligent, wonderful people will become as nasty and violent as the most bloodthirsty Klingon.
A Voyager that's constantly in need of repair, where the crewmen are lucky to get one meal, where sonic showers are something that they only allow themselves maybe once a month, where they have to face the unknown - an unknown that is more than willing to chew them up and spit them out - and they'll be at each other's throats after a time.
Basically, my mission statement is less 'get these people home' and more 'when a person is pushed to their limits, how long does it take for them to snap?'