Australia's consumer champion

Ms Hilda Bastian, chairwoman of the Australian Consumers' Health Forum, talked to Tessa Richards, associate editor of the BMJ, about how doctors need to work more equitably and effectively with patients.

Public debate on health issues is prominent and increasing. Political awareness of the need to take account of consumers' concerns is reflected in the UK government's NHS partnership strategy and within the restructuring of the European Commission. But Ms Hilda Bastian, chairwoman of the Australian Consumers' Health Forum and convenor of the Consumer Network of the Cochrane Collaboration, believes that “true” consumer participation in developing health policy and health service planning and provision is still in its infancy in most countries.

Lay input into healthcare decision making is largely tokenism, she says. The lay voice in expert committees is usually represented by a single person, who is easily intimidated by a team of health professionals Furthermore, the invited individual is often not aligned with a group of consumers and may lack advocacy skills. As a result it is easy to discount his or her views. More investment is needed in supporting and training people to articulate the views of the communities and patient groups that they …