Published: 10/01/2001, Volume 112, No. 5787 Page 22 23

Your correspondents from the NHS Modernisation Board (letters, pages 20-21, 29 November 2001) are right to welcome much of what the government has come up with in Patient and Public Involvement in Health: response to the listening exercise.

Particularly welcome is its recognition of a continuing role for a statutory national body, with a remit to support patient involvement and raise issues of concern to the public with the appropriate bodies.

This was only achieved as a result of the robust debate that the first attempt to abolish community health councils and the Association of CHCs for England and Wales engendered.

They are also right to point out that, for all the ambitious ideas to become reality, substantial extra funding will be required. So far, there is no more than a 'bid' for an undisclosed sum.

But they seem to have seriously underestimated levels of dissatisfaction with the proposals as they stand, involving as they do the abolition of CHCs and their replacement by what is widely regarded as a fragmented range of new bodies, likely to confuse patients and the public.

As recent surveys of local voluntary services and mental health advocates have shown, there remain high levels of support - if CHCs are to go - for something to replace them:

local, lay-led health watchdogs, capable of providing independent advice and support with complaints and taking an overview for their communities.

The government's abolition proposals have also faced widespread criticism in Parliament. Two of the three main parties have attacked the proposals, and the plans have been criticised by Labour MPs, including health select committee chair David Hinchliffe.

It is time that scrutiny of the NHS and public involvement stopped being a political football.

These are issues about which it should be perfectly possible to have political consensus.

Indeed, this is vital if the system that emerges from the legislative process is to be one that enjoys widespread public confidence. Abolishing a statutory local health watchdog of proven efficacy, without putting in its place a body capable of making sense of the local health economy, is unlikely to deliver such confidence.

We remain hopeful that some of the constructive solutions which we and others have put forward, that build on the best of the government's ideas while addressing the chief concerns, will be taken up.

It would be a tragedy if there was not a willingness to listen now when we have a once-in-a-generation opportunity to deliver a system that genuinely empowers patients and the public and puts them at the heart of the NHS.

Peter Walsh Director ACHCEW