What the article 'Patients are doing it for themselves' (3 August, page 16) failed to recognise is that everywhere, throughout the country, patients have long been 'doing it for themselves' - supported and energised by their committed community health councils. A CHC is not just yet another organisation.

It brings together, and is run by, members who may represent the local authority or local groups, but whose strength is that they themselves are patients. The CHC then enables all these diverse interests to work together cooperatively to improve local healthcare.

Newham CHC was pleased that Telco, as a local organisation not involved with the CHC, was able to focus for three months on our local hospital, before moving on to look at banking services.

It was particularly positive to hear that the issues they highlighted were exactly those that Newham CHC has consistently identified - through its long-term programme of visits, complaints work and surveys - as requiring action by Newham Healthcare trust. Given the regularity with which we put these issues to the trust, I am sure they were very surprised to hear the CHC's relationship with them described as 'cosy'. I think they would recognise 'uncomfortably persistent but constructive' as more accurate!

What is so worrying for patients about the structures outlined in the NHS plan to replace CHCs is that so much that we now have will be lost.

Where is the local overview of health services as a whole? Where is the in-depth knowledge embodied by CHCs? And what happens to independence and confidentiality (so important to patients) when you can only seek support from a hospital 'patient advocacy and liaison service'?

Your article makes it clear that under the NHS plan one-off shortterm surveys using 'crude measures' will replace ongoing monitoring programmes using a network of trained and experienced CHC members.

Which is why I, for one, believe that we should be saying no to a proposal that has so clearly not been thought about from the perspective of the very people it is supposed to be supporting - the patients themselves.

Marie Gabriel Chair Newham CHC