WHEN plans to abolish Community Health Councils were framed the intention was to set up new Patient and Public Involvement (PPI) forums.

The membership of PPIs would be drawn more widely from the community and be independent of the NHS so complaints and suggestions for improvements would be honest, impartial and constructive.

However, the autonomy of patient representatives has been compromised through a top-down structure of mechanisms.

These include financial, secretarial and contractual arrangements which are often poorly administered.

The volunteers enlisted have often experienced confusion and frustration about their specific roles.

Those more active and vocal in their criticism, instead of being welcomed for their fresh insights, have often been told "your services are not required".

Consequently, essential independence is absent, as is transparent communication.

Generally too many extra costly management and IT systems, which often include the appointment of further NHS staff, are being set up.

These should be one area for investigation in order to make substantial NHS savings and patient and public health should be given due priority.

P Scopes
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