The following article appeared in the December 2000 edition of Health Matters. For a free sample copy of Health Matters please email:

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"CHCs are a jewel – that is not well understood …There is nothing like it in the rest of Europe, where it is the administrators and doctors who decide".1

Mikko Vienonen , World Health Organisation European regional adviser

After 26 years of supporting complainants and representing the interests of the public and patients in the NHS Community Health Councils (CHCs), the only statutory patient-led NHS watchdogs, are to be abolished.CHCs are to be replaced by a number of different bodies. The proposal to abolish CHCs was fleetingly mentioned in the recently published NHS Plan. So brief was the mention that it is only now are that the full implications of the proposal are coming to light.

There is much to be commended in the NHS Plan, a long-term plan of modernisation and reform for the NHS. In particular, the commitment to develop a 'patient-centred' NHS is to be welcomed, along with the desire to enhance patient empowerment and involvement. The Plan is said to have been shaped by consultation with NHS staff, patients and the public. Yet the decision to abolish CHCs has been taken without specifically asking patients and the public whether their independent watchdogs should be abolished or about what could should replace them. The official reasons for the proposed abolition are unknown so there is plenty of scope for speculation. Have the 204 CHCs in England and Wales been too effective?

A broad spectrum of opinion including MPs from all parties, members of the public, professional bodies and patient's organisations have expressed grave concerns about the proposed new structures, questioning whether they will in fact strengthen, rather than diminish, patient empowerment and involvement in the NHS. Particular concerns have been raised about the fragmentation of CHC functions, the independence of the new bodies, and the absence of statutory rights for any of the new bodies.

Interestingly, although CHCs in England and Wales were set up under the same legislation, in Wales there are no plans to abolish CHCs. The Welsh Assembly has opted to consult widely and conduct research on the options for patient advocacy and support including the future remit of CHCs. There is a growing body of opinion in England that advocates such an approach. Change is needed but the current proposals are in danger of throwing away a 'jewel' and replacing it with a bauble - a system structurally incapable of genuinely holding the new NHS to account.

Angeline Burke


1. Pat Healy. Role Call. Health Service Journal 1998; Volume 108 No 5614: pp 12-13