Ian Semmons (Letters, 3 September) is mistaken if he believes that community health council members owe allegiance to any voluntary organisation or local authority. The virtue of CHCs is their independence, which is jealously guarded. But there is really no need for CHCs and the Patients Association to feel they have to compete. The public needs both. Their roles are complementary, sometimes overlapping, but different.

There are over 200 CHCs in England and Wales, all autonomous and rooted in their local communities. The Patients Association has no comparable local bases, but its members can feed their views on specific local issues through CHCs, and have them listened to and responded to at the highest level.

The CHCs' function is to serve health service users and patient-led organisations, and influence purchasers and providers.

I sit as a national representative of the Association of Community Health Councils for England and Wales on the management boards of several health- related enterprises, along with colleagues from the Patients Association. I have enjoyed the friendliest and most constructive of relationships with them, as we have always been on the same side.

Does it really matter who responds at national level on behalf of patients, so long as somebody does and it is done accurately, intelligently and effectively?

Joyce Struthers



Christine Hancock is right to point out that clinical effectiveness is not a patient's only indicator of high-quality care (Observations, 27 August). Cleanliness, building maintenance, catering standards and humane common sense can be as important, and affect recovery rate.

But she makes no reference to the long-standing role of community health councils as the patient's statutory, independent 'watchdog'. Reports by community health councils, the Association of Community Health Councils for England and Wales and CHC regional associations all testify to their research on nutrition, mixed-sex wards, patient dignity etc. And members carry out hundreds of quality-monitoring visits to hospitals.

At a time when CHCs are under scrutiny, it is well to remember one of their statutory functions is to visit and monitor hospitals from the patients' viewpoint and provide advice on complaining. They are the only bodies which have this right, and it is vital CHCs are not only allowed to continue to carry out their role, but are strengthened, so that they can do so more effectively.

Sue Wilshere

Chief officer

Association of Welsh CHCs