The real test of the NHS plan will be of its 'patient-centredness'. Setting aside the debate about the future of CHCs, I want to draw attention to the rich resources available should a genuinely patient-centred approach be adopted both nationally and locally.

But tokenism in the implementation of the seven elements of the plan that directly refer to patient and public participation will do enormous harm undermining the tremendous work of the independent advocacy and patients' movement of the past 20 years.

We have 20 years' experience of developing and supporting independent lay advocacy, working with our most vulnerable fellow citizens. Hundreds of local schemes, supported by national enabling networks, recruit and train local citizens to participate effectively in achieving healthier lives.

The disability movement and expert patient initiative, led by the Long-term Medical Conditions Alliance, have taken our understanding of self-determination and self-management of disease to a much higher level of personal and collective responsibility.

The Patients Association, in its submission to the NHS plan, called for direct patient involvement in the 'community governance' of the NHS by aligning patients' groups with primary care trusts.

Will the government have the courage to build on this work, and will it create meaningful partnerships with patients and their organisations to sustain and enrich the plan? The potential is there.

Bob Sang Strategic adviser, Patients Association Chair, Citizen Advocacy Information and Training, Brighton