Last update 10th. June 2004


Patients' Forum for the London Ambulance Service

Chair: Malcolm Alexander

30 Portland Rise, N4 2PP

Rosie Winterton

Minister of Health

Richmond House




Dear Rosie,

We would like to raise our concerns with you about the current review of "arms length bodies", which is being undertaken by the Department. Our particular concern is the widely held belief that the CPPIH will be absorbed into the Healthcare Commission in 2008.

The key issue for us is the fundamental importance of independence; an issue which has been raised many times in Parliament. It was Parliament's view that proper and adequate monitoring and scrutiny required the PPI system to be independent and you confirmed this yourself on November 12th. It is perfectly clear to us that despite the outstanding reputation of CHI and the high expectations that we have for CHAI, it would not be seen by the public and by members of Patients' Forum as a body that was sufficiently detached from Government to provide the degree of independence that Parliament intended for the PPI system. A widely held view is that the PPI would be swallowed up by CHAI and become a minor part of the activities of a body, which already has very many complex activities related to health monitoring and review.

Patients' Forums need to be "the real engine of the new PPI system" (Hansard 12th November 2004). This requires in our view a national body that can support the work of Forums as its exclusive activity. The activity of supporting over 500 forums is a complex and sophisticated one, requiring expertise in participative democracy and in the ways that communities operate. It is simply incomprehensible that this role could be carried out by any other than a dedicated body, focussed on the skills of community development, public involvement and the critical task of influencing health policy from the patient's and citizen's perspective. It would in our view be disastrous if this highly specialised work were to be handed over to a body that lacked the expertise to support Forums, patients and citizens and lacked the capacity to influence health policy from the patients' point of view.

You made the very important point on November 12th 2004 that "Parliament needs to encourage those people taking on the incredibly important role of scrutinising and helping to shape their local health services in an entirely different way". You described this role as "exciting and innovative" and said that you wanted Patients' Forum to flourish. If this is the case you must consider how disturbing it is for members of Forums who have been in post for less that six months, to hear that you are considering dismantling the CPPIH and absorbing it into another body. It is far more likely that you will cause despondency and alarm for the new members, than excitement at the new opportunities for innovation in patient and public involvement that you hoped for.

As it is clear that an announcement about the proposals for CPPIH will be make very soon. Can I therefore ask you to give a commitment that before any final decision about CPPIH is made, that you will formally consult with every Patients' Forum in England to gather their views on any proposals that you make. I think this approach would be entirely consistent with your own approach to PPI and to the nature and status of the body that is being examined.

I look forward to hearing from you in the near future.

Yours sincerely

Malcolm Alexander


Patients' Forum for the London Ambulance Service

The Patients' Forum for the LAS is a Statutory Body which Monitors Ambulance Services for Patients and the Public in London