Letters

Your reports on Dame Rennie Fritchie's call for an end to local authority nominees on health boards (news, pages 6-7, 23 March, news focus, pages 14-15, 30 March) raise some serious issues for partnership working.

There is a real danger that questions about 'cronyism' and 'vested interests' in appointments to public health bodies will be confused with issues of democracy and accountability to local communities. It would be a great pity if the legitimate role of local councillors on health boards was undermined by suggestions that it is somehow wrong for local councillors to speak up for the overall interests of their communities.

For example, the siting of hospital and ward closures do have an impact on local employment, and employment makes a difference to people's health, as the government explicitly acknowledges in many recent documents. What is wrong with elected representatives raising wider issues such as this to inform decisions on health boards? Doesn't it make positively good sense for councillors to be involved in planning health facilities, so that they can co-ordinate with other planning - for example, transport?

The statutory role of councillors on health bodies was removed by the previous government. Elected local government representatives are now entirely dependent on the politicised public appointments system, criticised by Dame Rennie, if they wish to play an active role on boards in promoting their communities' health. The government could easily remove the taint of partisanship in appointments by giving councillors a statutory role. In that way they would gain places on boards by virtue of their elected position in their local authority, rather than being seen as individuals' party political appointees.

Health improvement programmes, health action zones and many other government initiatives recognise the housing, education, environmental and economic regeneration roles of local government in contributing to health. The government must not allow weaknesses in the current appointments system to break the vital link between local government and health.

Dr Fiona Campbell Co-ordinator Democratic Health Network London WC1