Intended for healthcare professionals

Observations Body Politic

Come back community health councils, all is forgiven

BMJ 2009; 338 doi: (Published 27 May 2009) Cite this as: BMJ 2009;338:b2023
  1. Nigel Hawkes, freelance journalist
  1. nigel.hawkes1{at}

    Every change in patient and public representation since the demise of CHCs has been a change for the worse

    The Department of Health has announced that NHS organisations have a new target: proving they listen to patients. Instead of star ratings, they will be awarded “ears”—one ear for poor listeners, two for those who are at least trying to hear, three for those who can tune in to even the most distant bat-squeaks of disquiet.

    OK, I made that up. But I bet you half believed it. In response to the failings at Mid Staffordshire Foundation Trust, the NHS has suddenly rediscovered that customers may have something to tell it about the service it delivers. It wants their views listened to.

    This, from a government that abolished community health councils, invented a half hearted replacement called patient and public involvement forums, abolished those, invented another replacement called local involvement networks (LINks), and imposed on foundation trusts a preposterous form of governance with members, governors, and all the trappings of a pseudo-democracy.

    To make this machinery function, targets have to be imposed. Trusts will in future have to publish an annual statement about how they are fulfilling their legal duty to involve patients in decision making, publish the number of …

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