letters

Published: 23/01/2003, Volume II3, No. 2839 Page 23

While the establishment of the new Commission for Patient and Public Involvement in Health is to be welcomed, there are serious concerns that the statutory regulations governing its activity could undermine its independence to an alarming degree.

There have been many warm words from the government about putting the public at the heart of decision making, shifting the balance of power in favour of patients and the public, and placing national standards under local control. In particular, junior health minister David Lammy, the minister responsible, tells us that CPPIH will train the public in the skills needed to make their voices heard.

However, it is worth pointing out that alongside the supposed shift in the balance of power to patients and the public, greater power has accrued to health secretary Alan Milburn. For example, the CPPIH work programme requires his approval and 'may be varied... as the secretary of state may determine'.

Such a clause raises not only the concern that the health secretary will actively dictate the work of the commission, but also the worry that the commission will be inclined to limit its own statements and investigations for fear of the minister's intervention.

The health secretary wants to have his cake and eat it - he launches a major policy initiative to shift power to the people but actually takes greater power for himself. If the commission and the new patients' forums are to have the confidence of patients and the public, they must also have genuine independence.

The Association of Community Health Councils for England and Wales is seeking an assurance from the minister that his new powers will not be used to restrict the work of the commission.

Malcolm Alexander Director Association of Community Health Councils for England and Wales