Ifwe suppose that health secretary Alan Milburn is being honest when he says that he wants to see an extension of patient power, then we should be following the example of Wales.

Abolition of health authorities makes a lot of sense. What we need is a layer of elected regional democracy to control and plan development and fewer appointments of unelected and unaccountable stooges.

But we also need some discussion about the relationship between patients and citizens.

We are all patients some of the time.

Martin Rathfelder Development director Socialist Health Association London E1