I read with interest your story about the report on the future of community health councils (News, page 7, 2 July). It was indeed refreshing to be lectured on openness and accountability by the NHS Confederation and the Institute of Health Services Management.
It might be appropriate for them to look at their own democratic legitimacy before they investigate that of CHCs.
Suzanne Tyler's questioning of CHCs' democratic legitimacy seems to be centred around her statement that 'CHC members are appointed by the secretary of state for health'.
This is untrue. Half the members of CHCs are appointed by local authorities (and throughout the 1990s CHCs have been the only route into NHS decision- making for democratically elected representatives of the people). One third are directly elected to CHCs through elections usually organised by the local council for voluntary services. The electorate in this case is any local voluntary or self-help group that chooses to participate.
Only one-sixth of the CHC membership is appointed directly by the health secretary, and for these members CHCs are often a training ground for future non-executive director posts on trusts and health authorities.
If Ms Tyler's research was so cursory as not to reveal these basic facts then what confidence can we have in the rest of the report? My initial reading shows it to be full of factual errors and sweeping generalisations.
For example: 'It is generally acknowledged that the way in which CHCs work and the quality of that work is variable'. This can be said about HAs, trusts, clinicians, and NHS Confederation and IHSM members.
The difference is that CHCs have a long and honourable history of opening up the NHS to the public, challenging injustices and fighting for patients' rights - rather than being involved in cover-ups, persecution of whistleblowers and wasting NHS resources.
Chester and Ellesmere Port CHC