Community Health Councils were abolished in England a decade ago. Now Wales is thinking of doing the same.

In England, their demise led to a succession of failed initiatives. CHCs were replaced by Public and Patient Forums. They were then abandoned in favour of Local Involvement Networks (LINks), and we now have HealthWatch, with the jury still out on their effectiveness.

The Welsh Government’s plans are out to consultation until 29^th September, and the White Paper containing the proposals is called ‘Services fit for the future’. Click here to read the paper.

Part of the thinking is to replace CHCs with a ‘new national citizen voice’ which would ‘represent the interests of the public’ in health and social care. The new arrangements would be based in part on the Scottish Health Council (SHC), and would ‘sit alongside’ the Healthcare Inspectorate Wales and the Care & Social Services Inspectorate Wales.

Now anything that follows the SHC model is reassuring. It has worked well in most respects north of the border and was a beacon of sound public and patient involvement whilst the English floundered. But the consultation is silent on the all-important basis for appointing the new body. How representative will it be? How robustly will it be able to challenge policies or activities it feels are not in the interests of the public?

More worryingly, there are unanswered questions about the proposed process for public involvement on service change. There is a loud-and-clear message that the Government in Wales wishes to use co-production techniques to secure the right degree of public and patient involvement. It does not propose changing the law which requires genuine consultation (2006) but clearly wants to switch the emphasis towards inclusive continuous engagement and away from the set-piece consultations that have frequently proved controversial.

Much that is proposed in this consultation makes sense, particularly on continuous engagement, where the Institute is already working with Health Boards in North and West Wales.

But there are other important questions that need to be properly considered.

For example:-

• Will a ‘national voice’ and its local volunteers (however selected) command local support and achieve credibility?
• Will local authorities feel comfortable with a national body purporting to represent the views of electors where they have elected Councillors who may feel that this is their role?
• Will the general public still be given the same opportunity to be consulted on significant service changes?

These – and similar issues MUST be adequately debated.

To assist with this, the Consultation Institute is holding a special Roundtable to provide the perfect opportunity to consider the questions that arise. We have invited Richard Norris, who was the Director of the Scottish Health Council for many years to join the event and help us understand the lessons learnt from the Scottish experience. The Roundtable will be open to NHS Managers, CHC members and supporters and other stakeholder organisations, and is planned for 6^th September in Cardiff.

An outline agenda is here