Published: 30/01/2003, Volume II3, No. 5840 Page 22

There is still uncertainty about when community health councils will be abolished.While we wait, much of the NHS seems confused about what consultation arrangements for changes in provision are currently in force. I keep having to remind people to send copies of things to the CHC, from my council's health scrutiny committee to a trust considering a reconfiguration.

The Health and Social Care Act 2001 contains new consultation arrangements. These are neither complete nor yet in force. Only after CHCs' abolition - and then only in England - will consultation arrangements change. Consulting CHCs remains a statutory requirement for all changes in service provision in the NHS. CHCs currently retain their powers to object to inadequate consultations, request more information and refer disputed changes to the secretary of state. Any consultation that does not involve relevant CHCs is invalid and illegal.

Trust and strategic health authorities may include who they like in consultations. Where the local authority has set up an NHS overview and scrutiny committee, it would be unwise to exclude it. I sit as a CHC observer on this and feel it is most important that it works with the CHC to consider proposed changes while it still carries 'L' plates. At present, all the real power rests with the CHC.

After nearly three years' talks ofabolishing CHCs in England, legal provision for their replacement remains unsatisfactory and embryonic.

There is still no legislative provision for consultation on changes to trusts or primary care trusts after abolition. Many may be under the impression that existing CHC powers will transfer to oversight and scrutiny committees and patient forums. Only for major changes to SHAs do any such provisions exist. Unless this changes, abolition of CHCs will not lead to more public and patient involvement in the NHS, but only a number of expensive and impotent talking shops.

John Murphy Middlesex