Published: 15/01/2004, Volume II4, No. 5888 Page 8 9

The radical promises of the internet are not being fulfilled as trusts and campaigners find they get better responses through more traditional means of communication. Lyn Whitfield reports

One of the early promises of internet enthusiasts was that the new technology would change the nature of democracy. So how much impact has it had on the debate about foundation trusts, which are themselves supposed to bring the NHS closer to the people it serves?

On one level, the internet has made an enormous difference. It is now easy to find official documents, press releases, ministerial speeches, newspaper articles and other background material. The 19 November 2003 parliamentary debate on foundation trusts is available in full on Hansard online.

Former South Birmingham community health council chair and foundations opponent Ursula Pearce says: 'I use the internet a lot. I would be lost without it as way of finding government documents, or looking up questions to ministers and their replies.' E-mail is another useful tool. But on another level, the internet has made relatively little difference.

All 25 of the trusts going for foundation status in the first wave have websites and most, in turn, have used these to try and reach local people.

Addenbrooke's trust in Cambridge, for example, has a whole section of its site devoted to its bid. People can download the trust's consultation document, look at its proposed governance arrangements, find details of public events and e-mail feedback. People can also register an interest in becoming a member or governor of the new organisation, if it is set up.

However, trust head of communication Ruth Murphy says the web was only part of its consultation effort. It also ran newspaper inserts about its plans, put up posters and handed out leaflets in 'libraries, supermarkets, swimming pools...' 'There are a number of people who prefer to use the internet, but lots still prefer a leaflet, ' says Ms Murphy. 'Handing out leaflets also allows us to talk to people, and answer their questions.'

The trust's website receives about 60,000 hits a week.

From the start of September to the big night in Parliament, the foundation pages had received 1,675 hits. But of the 1,770 expressions of interest in membership the trust has received, just 30 came through the web.

Guy's and St Thomas' Hospital trust in London used both the internet and its well-developed intranet as part of its consultation on foundation status (which is being conducted in tandem with nearby Kings College Hospital trust).

Antony Tiernan, a member of the communications team, says the web is a 'developing media' - but the trust has also put resources into traditional mail shots, newspaper inserts, leaflets and public meetings. By mid-November, it had received 500 responses to its governance plans and 413 expressions of interest in membership - of which 5 per cent arrived through the intranet and 9 per cent through the internet.

Ms Pearce admits the campaign against foundation hospitals has been conducted using traditional methods such as 'public meetings, writing letters and talking to journalists', if only because 'we are not technologically savvy'.

Unions, think tanks and other organisations have published their public positions on foundation trusts on the web, but the one genuinely grass roots, anti-foundation website that seems to exist was set up after a public meeting in Oxford.

John Lister, a long-time activist with London Health Emergency which helped to organise the meeting and whose details appear on the site, says technical skills are not really the issue.

The foundation debate may have lit up Parliament and the national media, but it hasn't generated public interest or opposition, he says.This is in marked contrast to the public uproar that greeted the Conservative government's proposals for trusts back in the early 1980s.

'I remember going to huge public meetings in places like High Wycombe, where stockbrokers were turning out to say they didn't want their hospital privatised, ' he says. 'This time, the unions have fought the good fight, but they have tended to do it within the system, so proper public debate about the whole thing has been muted.'

Half of all households now have access to the internet, but its mere existence has not been enough to revolutionise public engagement, despite the fond hopes of enthusiasts and think-tankers.

Neither has the idea of foundation trusts.

Further information

UK Parliament www. parliament. the-stationery-office. co. uk

Addenbrooke's trust www. addenbrookes. org. uk

Guy's and St Thomas'Hospital trust www. hospital. org. uk

Oxford Campaign Against Foundation Hospital www. nofoundation. org. uk