Alan Milburn's behaviour is quite bizarre

I find it disappointing that, at this stage of the game, the Secretary of State for Health, while castigating Anthony Browne for "ill-informed journalism" and "complacent conservatism", should use your letters page (26 February) to rehearse criticisms of community health councils (CHCs) that have already been answered and dealt with elsewhere, not least in the House of Commons.

Some elements of his attack are curiously expressed. For instance, with regard to complaints: CHCs have never been resourced to deal with complaints, but many have struggled valiantly to do so. Nevertheless, they - and indeed any complaints organisation that may replace them - would find it difficult, I think, to deal with a complaint before it is made, or "nip problems in the bud before they occur", as Alan Milburn's wording seems to suggest.

The need for adjustment to methods of appointing CHC members was one of the issues highlighted in the report of the Commission on the Public Interest in the NHS chaired by Will Hutton. The commission consulted widely and the resultant report, New Life for Health, published in April 2000, acknowledged that CHCs played a valuable role in representing the public interest in the NHS. It was recommended that they should be reformed and strengthened. It was a shock, therefore, to learn that the government's own consultation apparently advised abolition.

The appointment of patients to trust boards is a poisoned chalice. CHCs have in many cases negotiated observer status on boards, with speaking rights. They have, however, resisted offers of full membership, for the reason that this could lead to conflicts of interest. As a full member, the patient representative would be bound to support majority decisions of the board, which might turn out not to be in the best interests of patients as a whole.

CHCs have always had the right to call snap inspections of NHS premises - so there is nothing new in this. However, there has, in my experience, been a good deal of resistance from management to the exercise of this right, on the grounds of inconvenience caused to hard-pressed staff and unplanned distraction from patient care. My own CHC was told that spot checks would be welcomed, provided we gave three days' notice!

In his penultimate paragraph, the Secretary of State enumerates some of the excellent initiatives set out in the National Plan, which have been enthusiastically acclaimed by many patient organisations, including CHCs. Alienating public opinion when he largely had it on his side, handing the moral high ground to the opposition, creating division within his own party, even embarrassing the Prime Minister - by making such a big issue of CHCs at this point - can only be described as bizarre.

Joyce Struthers
Chair, Association of Community Health Councils for England and Wales (1998-2000)
Member of the Hutton Commission on the Public Interest in the NHS

This article first appeared in The New Statesman Essay - Democracy can be bad for you

2001-03-05