Sir, Two years ago the Government abolished community health councils (CHCs) after 30 years of successful representation of patients. They fired thousands of skilled local volunteers and promised to create patient and public involvement (PPI) forums, at a cost of £35 million a year. Now, these are threatened with abolition (Comment, April 15).

Each CHC had a support officer who understood NHS issues and ensured that new CHC members were trained. The position with PPI forums is very different. The Government discriminated against the appointment of CHC members to the PPI forums. Instead, a “hotpotch” of voluntary sector forum support organisations (FSOs) was created.

When my forum seeks the organisation of proper training for its members, it is told either that it is the responsibility of the Commission for Patient and Public Involvement or that it has insufficient funds, although the forum has never been allowed to know what budget is provided or how it is spent.

The FSO involvement in the appointment of members has led to the resignation of more appointed people than my forum has members, through the early resignation of those who soon realised that they could not contribute to the work of the forum. It is clear that the FSO has no template of what is required for membership.

And yet forums have a record of outstanding achievements.Mine has intervened to help to improve provision of out-of-hours GP services and is now reviewing community mental health services in our district.

There are many people in the community who would like to help their NHS, but need to be given the chance with properly funded and structured support. It is wrong to abolish the forums before they have had an opportunity to mature.

IVAN LESTER
Chairman, Craven, Harrogate and Rural District PCT
Patients Forum

Sir, There was never a chance that these forums would succeed. In fact, when they were launched, Patient Concern voiced its suspicions that the aim was to fragment and disempower the patient voice.

Community health councils, which had often exposed the defects of the NHS, were abolished and patient forums became the new initiative. These initiatives are fast becoming a scandal, launching one after another without proper planning. When they don’t work, we are thrust into another reorganisation at a cost of millions.

Unless the Government is willing to set up a system that can hold local NHS services genuinely accountable to patients, even if they do not always like its findings, those millions will simply be thrown away.

JOYCE ROBINS
Co-director, Patient Concern
London SW5

Sir, The problems with patient forums have been twofold. One has been the lack of dedicated staff. CHC staff were dismissed, their expertise lost. The abilities of the voluntary bodies which took their place were, in many cases, inadequate. The other was the concept of public involvement and the requirement to access the “hard to reach” groups. Most people do not want to be “reached”; they want quality health services; they want to know where they can complain if they need to; they want to know that there is effective scrutiny of their local health services.

If the Government is to reform monitoring of the health service yet again, it needs to bear these things in mind, and to ditch the dogma that has made the past three years so difficult for those of us who simply want to help to make the system work for the benefit of the people dependent upon it.

ROBERT JONES
Vice-Chairman, Isle of Wight
Primary Care PPI Forum

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