Community Health Councils  were set up in England and Wales in1974 when  community  health services were moved from local authorities into the NHS.  During the 29 years of their existence they developed  confidence in challenging the NHS locally and nationally. An official national Association of CHCs in England and Wales was established with funding which provided legal advice, training and support, and perhaps most important, leadership. The staff were employed by Regional Health Authorities and many developed considerable expertise. RHAs generally did not interfere with the running of CHCs, even though some of them clearly annoyed local NHS managers – and doctors – as one of their jobs was to support people with the complaints procedure.

The main work of CHCs was in challenging local NHS decisions, especially relating to “substantial variations” in the provision of services, and in inspecting services, as they had the right of entry to NHS premises.

Doctors Private Quarters

Doctors Private Quarters

The best publicised campaign CHCs ran was called Casualty Watch. Southwark CHC started visiting Kings College Hospital casualty department on the first Monday evening of the month and issuing a press release on Tuesday morning telling the stories of the people they found waiting there. The campaign eventually covered the whole country and was full of stories like the 80 year old man who waited 120 hours at the Royal Free Hospital. By the time of the last national exercise in 2001 187 casualty departments were visited, the CHCs were working with the Royal College of Nursing and they were generating a lot of publicity.  Local papers loved it and it seems pretty clear that it was because of this that the 4 hour target was imposed on casualty departments.

In 2003 Community Health Councils were abolished as part of the NHS Plan – the only part subject to no consultation or public involvement. No explanation was forthcoming, but those involved assumed they had become too much of a nuisance. The gap between abolition and establishing new organisations conveniently prevented any of the staff, some of whom had become quite expert,  having a claim on a job in the new structure.

In 2003/4 CHCs were replaced by patient and public involvement forums – one for every NHS Trust. Instead of having their own permanent staff the forums were supported by local host organisations – mostly voluntary organisations – on short term contracts.  There was a national body, the Commission for Public and Patient Involvement in Health, (CIPPIH) which appointed the members and attempted to police the system. The forums were pretty well strangled at birth, as it was announced in July 2004 that they would be abolished by 2008. Most were small and ineffective, but they weren’t around long enough to develop any strength. The Patient Forum in Mid-Staffordshire was worse than ineffective. In January 2006 one of its members produced  a report on the shocking state of the casualty department, but the Patient Forum refused to pass it on to the hospital. When he gave his report to the local paper they expelled him. Many of the Forum members went on to take non-executive positions in the NHS.

From 2003 local councils were required to establish Health Scrutiny Committees with powers to call NHS organisations in front of them. Some did excellent work, often across institutional boundaries and with a public health perspective, but many were under-resourced and lacked expertise in health issues.

In 2008 the Forums were abolished and replaced by Local Involvement Networks – run on similar lines with a host organisation with a 3 year contract providing the staff. Unlike the Forums, the LINKs related to a local authority area, not an institution and for the first time were expected to cover social care.  That was a quite a shock and many LINKs concentrated on social care as a new and challenging area. Links were entitled  to “Enter and View” premises where NHS or social care services were provided. They had no national or regional structure.  An unofficial structure was set up – the National Association of Links Members which helped to keep people in touch  – but it never had any official recognition.  So there was no national leadership  and LINks consequently lacked direction and were allowed to drift  depending on who was involved. The task of monitoring the whole health and care system was, in any case, beyond the resources at their disposal. They were supposed to involve organisations as well as individuals, but the big health charities didn’t see them as offering anything they couldn’t do perfectly well on their own.

Alongside these structures NHS Trusts were being turned into Foundation Trusts, the idea being that they would be independent organisations operating in a competitive market. They have members, (self-selected) who elect the Governors of the Trusts. This was a new departure for the NHS, and most of the Trusts didn’t  know what to do with them. Some tried to recruit large numbers of members, until they realised that servicing them cost about £9 a year each.  Most were very wary of letting the governors interfere.  As far as many Trusts are concerned Governors are an ornamental part of the constitution, to be taken out on festival days  and introduced to visitors, but to be kept away from the operational parts of the organisation.  Most of the Governors see their role as similar to that of the Friends of the Hospital. They generally don’t know much that the management doesn’t tell them so the idea that they hold the board to account is seldom a reality. Their role is further weakened by all the other bodies that hold the board to account. In places where Governors make a real contribution it’s usually because the Chair of the Trust, who also chairs the Governors,  takes a positive view.  If something goes seriously wrong the Governors are generally reduced to the role of spectators while Monitor, or some other regulator, intervenes long before they can act.

In Mid-Staffordshire as far as Cure the NHS were concerned none of the involvement structures – Patient Forums, Local Involvement Networks ,  Foundation Trust Governors  or even the Trust Board – seem to have had any credibility.  Julie Bailey and her associates treated  them with contempt.

On April 1st LINKs are to be replaced by ‘Healthwatch’. In many ways quite similar in that they relate to a local area. Each of 152 local authorities has to commission fund, and performance manage its Healthwatch, and generally this means a 3 year contract with a voluntary organisation to set it up, though 7 are run by social enterprises set up by commercial organisations. The remit is a bit wider than LINKs, as Healthwatch has a role in advising patients about services and complaining. They will still be allowed to “Enter and View” premises where NHS or social care services are provided. Funding is tighter and not ring fenced. And local Healthwatches will be organisations in their own right with the power to employ staff, where LINKs were just run by their “host” organisation. Healthwatch gets a seat at the new Health and Wellbeing Board to be set up by each local authority, and that may create its own problems as the Boards grapple with unpopular reconfigurations. They will also be represented at the NHS Commissioning Board’s Local Area Team’s Quality Surveillance Groups. But there will be no common pattern of organisation. Just as with LINKs, each area will be different.

There is a national organisation – National Healthwatch “hosted” by the Care Quality Commission, and among other things it will do some national advertising, as CIPPIH did, to promote the “brand”

The Healthwatch regulations provide that they are not allowed to promote or oppose changes in “the policy adopted by any governmental or public authority in relation to any matter”.   Norman Lamb, the Minister,  says that “to be effective, Local Health Watch should speak out for their local communities, ensure their campaigning work is evidence based and that they are not captured by political parties or other organisations.” He has said that as a lawyer he agreed that the wording of regulations could be improved but felt that they allowed for campaigning and confirmed that the government wants LHW to campaign. He added that most community organisations would look to guidance rather than statutory regulations and suggested that LHW could use Judicial Review against local authorities which try to stop campaigning.

It seems very clear that the organisations which get the Healthwatch contracts will feel very vulnerable to accusations that they are “campaigning”.  Each successive iteration of the PPI structure ends up more timid than the one before it, and this appears to be the going down the same road.

It’s well established that reorganizations set back progress.  That is even more true of voluntary organisations. It will be difficult to persuade the population that Healthwatch is worth the investment of their time and energy.

For people who want to get involved in the NHS there are other opportunities. Clinical Commissioning Groups are required to establish public and patient involvement structures, and at present the signs are that they are much more interested in listening to the public than PCTs were in their later years.  There are financial incentives for GPs to set up patient participation groups, and some of them are quite active, though many GPs are very wary of them.  In the new more chaotic NHS structures and informal arrangements are springing up that have been variably. They may do more than the statutory arrangements. It will deeply ironic if the new competitive ethos in the NHS leads to a market in active patients with many organisations bidding for their time

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  1. Mohammad Al-Ubaydli says:

    This is a brilliant article, I had never seen the history so nicely explained before. Do you know the name of the whistle blower who have his report to the press and was expelled by the mid staffs forum? Before the press goes on witch hunts I wish they would start by celebrating and apologising to the heroes who tried to blow the whistle.

    1. Anita Higham says:

      Martin – Overall excellent – but unlike LINks, LHWs have amongst their the statutory functions the duty to monitor the quality of both commissioning and provision of all Social Care services for Chldren and Young People – except for Enter & View of residential care establishments – that is the duty of Ofsted.
      LHW, as statutory representative members, must also challenge their fellow Health and Well-Being Board members who are the various commissioners, where they do not comply with the strategic plan for the improvemnt of the health and well-being of the population of their area, based on the joint strategic needs assessment.

      1. David Gaskin says:

        Thanks Martin for the summary it clearly sets out the path both governments have taken with regard to the input of laymen, and their way they used the PPIF, and link, to help them set out the future of the NHS, you also rightly in my opinion, say both the PPIF and the link were never given the chance to prove them self’s from the outset. I also agree with Tony and others here, when they say things changed when the councils took over the links, and the government removed the powers regarding the 28 day rule, that forced the PTC and local health trusts from pushing reports and recommendations, given to them by PPIF under the carpet. Another thing I fear is the new LHW will lose even more independence, once businesses and charities get involved, as they will inevitably be financially linked to some of the things they do. The other problem I have with LHW is the remit; it is so vast, that I fear they won’t be able to cover it all properly and If they fail to do it, that will allow the government to scrap it, and that will be the end of this experiment with regard to patients keeping an eye on the NHS .That would allow the government to save money, and would leave the government, with an open door to carry out further reforms without patient opposition

  2. Francesco Palma says:

    Hi Martin

    In Bristol, South Gloucestershire, Bath & North East Somerset and Somerset one VCS organisation has the contract to manage the Local Healthwatch contract, other than the Healthwatch website for each of the 4 areas little else exists to herald the start of Healthwatch, no chair, no Board of Directors nothing. Give it 3-6 months then things maybe different but in the meantime the Health & Well Being Board/CCG’sNHS Direct/NHS 111/Clinical Senates/Strategic Clinical Networks Etc will be in place Having been involved from the latter days of CHC’s to LINks up to 31/03/2013 I think that the ‘narrative and perspective, of the user of services in heath/social/public care has been consigned to the VCS and away from the individual volunteer.
    Regarding campaigning, the recents Regulations make clear that this is not a remit of Healthwatch.
    Local Healthwatch will not be reflective on local communities of interests concerns if LA’s funding for LHW is similar to LINks funding. THUS LITTLE SCOPE FOR COMMUNITY DEVELOPMENT/ENGAGEMENT.

  3. Neil Woodnick says:

    Thw whole model of PPI is totally flawed because it’s really about making a totally disenfranchised electorate think they can influence how billions of pounds of taxpayers money is spent on health and social care.
    If you want to see who really holds the power in the NHS and Local Authorities it’s easy, just follow the money. Those who control the money doing the ‘kicking’ and everyone else gets ‘kicked’.

  4. Elli Pang says:

    Hello Martin, that’s a good, easy-read history of ppi and having been part from the beginning of the PPI Forums more than content with your description of the variable performance; outcome often very controlled (by Host organisations either through ignorance or self-interest for their core business usually paid by eithr NHS or LA. The same applied, of courese not always/everywhere, but too often, under LINKs. One wanders hopefully towards the next ppi incarnation. With the ever widening of the ‘market’ and ‘levelling of the playing field’ (Monitor’s report and varius NGO’s reports) but allowing third sector and private ‘businesses’ to be largely exempt from FOI or disclosure of the contract specificiation it is unclear how LHW will be able to monitor anything. The current, optional fOI clauses, available to both NHS and LA are weak and can only be accessed by the public (and LHW?) via the commissioners. Unless service provision is strictly and INDEPENDENTLY monitored – assurance – won’t work. Enough for now – Elli.

    1. Martin Rathfelder says:

      I’ve been told that services commissioned by the NHS have to respond to Freedom of Information requests. It’s a contractual requirement. Can anyone verify this?

      1. As far as I am aware commissioned services have to respond to FOI but only via the commissioning body, i.e. HW will have to write to CCG, for instance, who will then get the requested info from whoever the provider is. That’s also how it worked in terms of social care under LINks. Don’t take my word for it tho. Here’s an explanation from law firm Mills & Reeve:

        “Current FOIA regulation of providers
        Currently, although private healthcare providers are not subject to FOIA, the NHS bodies that commission their services are. NHS commissioners are therefore under a duty to respond to any FOIA requests regarding the services that they commission. NHS commissioners use the terms of their commissioning contracts to ensure that providers assist them in complying with FOIA.

        The NHS Standard Contract 2013/14 obliges all providers of NHS services – whether public or private sector – to assist and co-operate with commissioners to enable them to comply with their obligations under FOIA. In particular, GC 21.5.4 of the NHS Standard Contract requires that those providers that are not subject to FOIA themselves, do not respond to any Freedom of Information request they receive but transfer within two operational days to the Commissioner.

        However, the scope of GC 21 is limited as it applies only to any information held by the provider on behalf of the Commissioner for the purposes of the contract, rather than information about the private healthcare provider itself. While this may deal with issues about transparency of service delivery, it does mean that private healthcare providers are not subject to direct scrutiny by the public and also they do not have to deal with requests for financial commercial information about themselves. For many this represents an imbalance and does not constitute a “fair playing field”.

  5. Caroline says:

    Muhammad, if you read the Francis report its all in there including the name of the whistle blower. Makes for very tragic reading and HW must learn from this.

    Re campaigning : there is guidance re campaigning and it relates to political activity. No one is saying there cannot be a campaign locally or nationally on a particular issue regarding the quality of care. To have effective representation on the issues you have to have the right people who have the skills and knowledge to do the job. There is a real risk of information overload and people in voluntary positions need to be supported to carry out their roles in an informed way which uses public funds to the best. This means robust data collection using technology and a variety of methods and presentation : frankly some of the “reports ” I have seen which were produced by PPi forums were not worth the paper they were written on.
    There needs to be acceptance by some people that well qualified and informed professional staff are necessary to enable the maximum amount of people to carry out the rep role in all parts of the new arrangements. No one can do this on their own. More positive thinking I say and collaborative working. If the VCS don’t do it who else can? The private sector?

    1. Martin Rathfelder says:

      The regulations say very clearly that Healthwatch money cannot be used to campaign about “the policy adopted by any governmental or public authority in relation to any matter;” The guidance says different, but that is the law. So that would prevent campaigns about staffing levels or waiting lists.

      1. Caroline says:

        As long as HW can demonstrate its remit to promote and support involvement in commissioning, provision and scrutiny of care by enabling people to comment on the quality of care then that’s fine. This seems to indicate evidence, and real time feedback, not intellectual arguments about potential policies. if a policy changes as a result then thats permissible. its a legal argument yet to be tested.
        And nobody’s stopping anyone from campaigning to MPs?

    2. I wholeheartedly agree with your point that “well qualified and informed professional staff are necessary”. Unfortunately, in my experience LINks/LHW employees are paid significantly less and have significantly less other benefits than their equivalent within the NHS or local council. Surely, this in itself puts independent overview and scrutiny through LHWs on the back foot as qualified staff will seek to gain more profitable employment within statutory providers. And I won’t even mention the significant gap between funds statutory bodies are able to spend on PPI and those made available to LHW in certain areas. With all the will and volunteers in the world you cannot possibly stand up for patients and service users in those instances. It’s a David and Goliath story without the happy ending…

  6. Andrew Craig says:

    Thanks for this good summary Martin. We agree about the better opportunities for CCGs to be listening organisations compared to many PCTs, but the window to exploit this will not stay open indefinitely. We talked to a sample of 6 CCGs who were not in the “pathfinder wave” in late 2012 including their lay Board members. They were in the process of embedding PPE, but it was not complete and might not be completed before they were flung into difficult decision making situations where local understanding and support for change was essential. They were desperate to avoid confrontation and wanted to work in partnership – many were already doing so – but they realised that they could be hemmed in by swiftly changing events. Their most obvious need was for organisational development support for better engagement, including metrics to measure effectiveness of engagement. Our report makes specific suggestions for this. This OD help should be delivered in a tailored and targeted way in order to address local issues and achieve quick results so that trust can be developed and the CCGs’ room for manoeuvre does not become restricted. See details here

  7. Caroline says:

    The FOI act has a schedule to show which public sector orgs are liable. In theory if an org is publicly funded then its liable – and if public sector outsourcing the contracting body may very well include clauses to ensure it can comply with the duty where a request was made for data that could be passed on without contravening the exemptions under the act: i e commercial interest , personal data, disproportionate time spent retrieving info or vexatiousness. You would need to look at NHS Commissioning Board Requirements to garner any clues, Martin! Hope this helps?

  8. ruth marsden says:

    Better to say that the ‘national organisation’ is Healthwatch England, because that’s what it is. Its statements to date indicatedf it sees no role in sorting out the problems which are already surfacing and will ineveitably arise with Local Healthwatch.
    As Martin says, this is the 4th incarnation of statutory patient and public involvement and each one has been shackled and stifled in a different way. The National Association of LINks Members, not being funded by government or by the LGA, was and is free to ‘tell it like it is’, and thus provided much of the evidence for the attempts, inside Parlaiament and outside, to get better law and better regs for HW.
    The Act setting up HW came during Andrew Lansley’s tenure as S of S, and what he promised in his planning conference for HW was all jettisoned when he came to power. [
    Rhetoric is easy and we have had far too much of it. Having been involved in ppi/ppe for 12 years, I know many colleagues who volunteer who bring such talent, skills and experience that their salaries’ bill could not be afforded by the D of H.
    Abuse of shocking proportions took place at Staffs. Abuse of a different sort but similar proportions has left too many volunteers disaffected, disillusioned, frustrated and angry. The tragedy is that their talents, commitment, capacity and presence on the ground has never been more needed.
    Ruth Marsden, Vice Chair, NALM.

  9. Trevor G Plunkett says:

    A well set out expose of the different organisations set up to help get the general public I.e. potential pts.have some sort of say inl how THEIR NHS was to be run.I have been involved with nearly every committee you mention, finishing as aGovenor at N&NH UT. We obviously were there as a shop front. My wife who has Alzheimer’s dementia was admitted with a strokep and in my view was treated abominably.I complained directly to the chair of the Board of Directors, who promised action, regarding specific points. Nothing happened. He has just been appointed chair of the CQC. That speaks volumes. Trevor Plunkett(Dr rtd)

  10. Ed Murphy says:

    Good information here and has motivated me to do more as a governor at CPFT

  11. Good basic stuff Martin but much more varied locality to locality than you thought. Here (in Norfolk) CPPIH civil servants were incompetent in service user involvement, especially our regional manager. You might recall we (several PPI areas, especially Camden in London) campaigned against the ineffectiveness of the setup. Malcolm Alexander, now chair of NALM – a far more effective and important organisation than you indicate – was one of the leads which led to the setting up of the National Association of LINks Members. There was a good website (ppif) reporting on developments, the archives of which will be of historical value. You might also remember my own website ( which was closed by CPPIH. I still have the files.

    Those clashes with CPPIH are important today in terms of learning. In the context of accountability in particular, I agreed to help someone expelled from PPI because he had a dispute with CPPIH. We eventually took the issues to the Health Service Ombudsman who ruled that the organisation could not investigate complaints by PPI volunteers because they are considered by the Ombudsman to be ’employees.’ That is most likely to apply to HealthWatch.

    1. Martin Rathfelder says:

      This account is deliberately sketchy! I find it very difficult to understand how healthwatch will operate.

  12. janet Upward says:

    Dear Martin,
    many thanks for this very helpful summary. i think you might usefully say something in the CHC bit about the role of the Chief officer in helping patients through the complaints system. this would have been another avenue through which the Mid Staffs horrors could have come to light.

    Thanks also for explaining about Health Watch. it seems worse than useless. Given that the NHS is going down the path of turning patients into consumers, inevitably the provider organisation will seek to pursue patient and public involvement as part of their marketing strategies, without giving their patients an independent collective voice.

    Before i became a CHC Secretary ( as it was in those days) i had been involved with the consumer movement, running the National Federation of consumer Groups throughout the 1970s. It was originally a development of Consumers Association, although we had an arms length relationship. the important point is that even in consumer affairs in the commercial market place for goods and services, it was recognised that consumers need collective action to promote their interests with producers and suppliers.

    janet upward

  13. Tony Lloyd says:

    I echo the views of others about this summary. Two major problems with LINks were a) that evidence based recommendations from LINks were and still are frequently ignored, without fear of recrimination, by PCTs, CCGs and by Trusts even if HOSCs support them and b) that there is a huge conflict of interest issue when local authorities are given the responsibility for commissioning LINk and now Local Healthwatch. The implications of these two issues would take many paragraphs to outline but are largely responsible for the collapse of interest in LINks and the scepticism about LHWs.

    1. And I would echo Tony’s points re LINks/LHW evidence being ignored and the conflict of interest for local authorities being largely disregarded despite it going directly against the crucial principle of LINks/LHW independence. The former is especially frustrating as in my experience statutory health and social care bodies rarely present any evidence at all for the decisions they make but then downplay the vital evidence provided by LINks/LHW as “mere hear say” or “anecdotal”. What is the purpose of investing in independent patient and service user involvement at all if it is neither independent, nor taken seriously by the services it is supposed to monitor and improve?! The cynic in me would say the prime function for LHW seems to be to keep the public occupied and their attention on something trivial while the important decisions are being made…

      1. rogue neuron says:

        Cynic? I think not. Your conclusion is as true for those LHW organisations that are seemingly ‘healthy’ as it is for those (already) dysfunctional LA puppets – and many people at the Manchester HWE event told me privately just how bad things are. Still, glossy reports, outcomes and boxes ticked…

  14. datagoat says:

    Good article Martin – excellent summary of the history and analysis of the issues.

    I published some of my thoughts on today’s Westminster Briefing:

    I really think that a more professional service is needed for local people. But with budgets being very tight for Local Healthwatch and the remit being much wider (including children’s social care) I cannot see how this will be effective.

    I also think that LA’s will force Local Healthwatches to “demonstrate” that they are ‘doing more’ – such as engaging with children’s social care – which will detract from areas which local people know need more – and not less – scrutiny.

    Best wishes, LUCY

    P.S. There’s a useful list of Local Healthwatch Providers here:

  15. Henry Goldberg says:

    Overall a good summary, Martin. I would add a few other points based on my local experience.
    Another significant acheivement by CHCs was when S.W. Herts CHC objected to the SoS of the plan by the local Health Authority to merge their two acute hospitals. As a result of the objection the plan was dropped and there were two further significant outcomes. First the local Health Authority and its successors gave much more careful consideration to future public consultation processes. Secondly, later proposals for hospital rationalisation included roles for both the hospitals.
    Regarding PPI Forums, there was one per Trust, but in Hertfordshire the Forums met regularly and worked together. When LINk was formed we managed to carry forward the arrangements for public representation at the Trusts and PCT. Herts LINk became a member of the shadow Health and Wellbeing Board for Hertfordshire when it was formed, and this membership has now been taken on by the LHW. The LINk also had members on the boards of the two (pathfinder) Hertfordshire CCGs. During the five years of LINk, we managed to work independently, but very positively with the County Council as well as the local NHS. However, with the local government responsibility to commission the LHW, it is not at all certain that the same level of independence will be maintained. We have to see how it works out.

  16. G Webb says:

    Can anyone confirm if the board of the new HealthWatch will be elected by the public or appointed by a “panel”

    1. Tony Lloyd says:

      Regarding the Healthwatch Board, there are no fixed rules. In our area some Local Authorities have engaged Host Organisations and contracted with them for the provision of Healthwatch with the usual contract monitoring provisions. They have then advertised for applications for Board Members. In one case they have appointed an independent interview panel. In another, they are doing the selection themselves. In both cases they have defined roles for those Board members e.g. finance, governance etc. They have reserved Board places for themselves. In both cases the Healthwatch Board will be unable to employ its own staff or control its own bank account.

  17. Maria says:

    I think that before everyone starts to talk about failure of LHWs please lets be positive. yes times are fast changing and resources are tight, yes, LHW cannot monitor and scrutinise the quality of every service that is provided in its locality and actually there are statutory mechanisms in place for doing that (CQC, Monitor, Scrutiny Committees etc) – surley it about ensuring they do they this properly (after all they are getting the big bucks to do this).

    however, LWH will develop their work programmes based on what people are telling them and work on those issues on behalf of their LOCAL people and if each area is realistic about what it can acheive and works within its resources – you wil have far greater effect and with the support of your local people and thus attract more engagement with them. For example winning a battle to greatly reduce waiting times for Hearing aid repairs has more credence with local people than attending regional and national meetings complaining about the state of the NHS.

    It is not about fighting with central government for LHW – this is what HWE should be doing (and i realise that this has its own inherent difficulties) and for those that have views of government policy – they should be feeding this to them.

    for what it is worth everything NALM has written isn’t necessarily true. the LINk i was involved with were misquoted and mis-reported.

    The LHW i am involved with has set up its own company with a board of previous LINk members – ELECTED by the general public, the HW money is in our bank account, we contract our own staff and feel it is independent. should ppi arangements change in the future – they may be able to stop our funding and change the rights, but they have no power to close a PLG company down. we have good relationships with the statuory sector and we feel they do listen and act on our feedback.

    my plea is simple – give some credit to those who have tried to make a difference and those who are prepared in these tough times to continue to make a differernce

    1. Tony Lloyd says:

      It is heartening to hear that some local authorities are so enlightened. Our LINk worked with the voluntary sector for two years with the active encouragement of the local authority to set up local healthwatch. We set up a CIC, had governance arrangements in place etc but then, at the last minute, the LA procurement team stepped in and said that the commissioning of LHW had to go out to tender and we lost out to one of the corporate social care providers that was slicker at scoring points in a tender evaluation exercise. Now they are starting again from scratch.

      1. maria says:

        I am sorry to hear that Tony and flies in the face of what the original brief was. we are lucky our local authority have been very supportive and kept true to its belief that they wanted to build on a strong local presence. also i think the LINk members may have protested (dare i say campaigned) to ensure that the work that they did and owned was continued by them and quite rightly so. some local authorities have a lot to answer for and may have done much damage to the reputations of LHW being independent and effective that we are hering so much about.

  18. Robert Jones says:

    A good and accurate summary, which means of course that I agree with it (and could have written it ….). My only problem is the (rather untypically) sunny view of the CCGs: granted, I only have experience of one; but thus far it appears to have nothing to say for itself and has not communicated with those patient groups which exist in the local hospital, despite an invitation to it to do so. From the outset, ie from Milburn’s butchery of CHCs, this whole process has been about marginalizing any EFFECTIVE patient voice, and replacing it with the illusion of “involvement”. I note the cri-de-coeur above to be positive and to give the new arrangements a chance, but a) some of us have been positive over the last 10 years and have had our faces rubbed in the failure of this charade time and again, and b) that assumes it’s all supposed to really work in any sense other than providing a fig-leaf. This government, just like the last one, regards patient involvement and engagement as good things, provided they don’t actually make any difference or embarrass ministers – especially the latter.

    Patient involvement started life as a fraud, has been a fraud throughout, and will die – I hope – the death of a fraud,

    And Martin describes HIS view of local healthwatch as “a bit jaundiced”: you see how very far he still has to go before reaching my fetching state of custard yellow.

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