Your cover feature on the role of the health service commissioner ('The fixer', 8 October) misses the point in relation to people's continued dissatisfaction with the NHS complaints procedures.

People accessing Salford community health council for help and advice with their complaints are increasingly concerned by a perceived 'conspiracy theory'.

Look at the procedure through the eyes of the average complainant. Their complaint is initially investigated by the very people they are complaining about. If they are unhappy after these investigations they can then ask the same people for an independent review into their case.

There are no guarantees that a review will take place - a complainant may only request one. There is evidence that some areas of the country have a poor track record in setting up review panels (Public Law Project - report due 1999).

If a panel takes place, the complainant may (or may not) meet an independent person. It is hard for us to reassure, the by now frustrated, complainant that the process is transparent as the lay chair has control over who sits on the panel. Neither the complainant nor the CHC officer will have had the opportunity to meet the lay chair before the review takes place.

Even access to medical records is fraught with conspiracy theory problems. Asked only yesterday who was to stop a practitioner changing a patient's notes, one could only answer, 'I don't know'.

The complainant's only access to any true form of independent scrutiny is via the health service commissioner's involvement in the case. This unfortunately comes at the very end of a long, drawn-out, often unsatisfactory process. Not at the beginning.

Shall we set up our own 'X-Files' - the truth must be out there... somewhere.

Wendy Goodwin and Tracy Steward

Salford CHC