Three ministers addressed the NHS Confederation's conference in Harrogate. The health secretary emphasised his support for sound management, and even mentioned non-executives twice. So it is hard to understand HSJ's suggestion that the confederation has a low profile, and no longer has the ear of ministers ('Confederate flagging', 27 May).

The confederation has learned much from its membership audit. This has not only provided the basis for linking aspirations to projected income, but turned this year's conference into a true membership event. Delegates had the opportunity to interact with those working to improve health in a modern NHS.

With a strong mandate to lobby, comment, influence and inform, the confederation has made great strides in building a clear corporate identity. It has taken firm steps to ensure the views of NHS management are noticed in Parliament with its MPs and peers contact programme, evidence to select committees and parliamentary briefings. Members have been kept up to date on the passage of the Health Bill.

But there is much to do. A new approach to member involvement is being launched by establishing policy advisory committees. In addition to the regular briefings, updates, and policy documents, emphasis will shift from informing to involving, with policy achievements and activities promoted on the Interchange web site.

The organisation is seen as a provider of an independent and comprehensive view of the NHS, according to a recent perceptions audit. The 1999 conference, with its focus on influencing policy, has produced positive feedback. It seems the critics were wrong after all.

Dianne Jeffrey


Community Health Care Service (North Derbyshire) trust