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Excellent article; successive SoS have faffed and fiddled around with patient engagement models, and the only effect has been the accelerating demise of of the patient voice in parts of the NHS.

Lansley is only the latest culprit in this; he has argued that the patient voice is best heard through the direct Dr/Patient interface when planning a referral/admission/care package. Well, up to a point, Lord Cropper. It works (sometimes) for elective care or OP, but doesn't really address the fact that:
- an enormous number of patients are emergency admissions
- individuals and communities have a legitimate right to be heard on servives, even if they aren't currently patients or seeking care
- the dialogue should also be with groups and communities of interest, not just individuals
- it doesn't address hard to reach and traditionally excluded groups

I could go on. However, Wales has mainatained and consolidated the statutory role of CHCs; as a model it's a good one. They are a clearly identifiable body with clear stautory roles and rights, and there's a real benefit in that.