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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 April 28; 334(7599): 869.
PMCID: PMC1857778

Reform of NHS patients' forums unnecessary and unproved, MPs say

A bill going through the UK parliament that abolishes patients' forums and replaces them with larger bodies has been criticised by MPs. They say evidence is lacking of any benefit and that the bill risks losing the patient volunteers who have brought about valuable changes in the health service over the past three years.

The Local Government and Public Involvement in Health Bill proposes establishing Local Involvement Networks (LINks) in the place of patients' forums, 400 of which have been established in England since December 2003.

The new bodies will cover social care as well as health and are intended to attract a wider and more representative sample of the community to consult on the provision of services, including young people and ethnic minorities, something patients' forums have failed to do.

However, in a report, MPs from the cross party health committee conclude that they are “not convinced that PPIFs [patient and public involvement forums] should be abolished.”

They add that patients' forums could have been allowed to evolve into the larger organisations envisioned by the government in its proposed bill by merging them.

“Merging the existing PPIFs to form LINks would have been much less disruptive for volunteers and would have reduced the risk of significant numbers of them leaving. Once again the Department [of health] has embarked on structural reform with inadequate consideration of the disruption it causes,” says the report.

MPs are also angry that the bill modifies section 11 of the Health and Social Care Act, 2001, which places a duty on health authorities and trusts to consult patients and the public when planning or changing the services that they provide. Under amendments, consultation is only needed for “significant” changes—a modification the report says is unnecessary and which will weaken the obligation for providers to consult patients about changes to services.

The report calls for greater clarity as to the functions and remit of LINks, their funding, and how they will be made accountable, something which is not made clear in the proposed bill, it says.

Sharon Grant, chairwoman of the Commission for Patient and Public Involvement in Health, said, “We concur with its [the report's] substantial conclusion that the current proposals to reform the system for public voice in health are flawed.”

The Department of Health announced in July 2005 that the commission, which was set up to oversee the forums, is to close in July this year.

Ms Grant added, “In particular the lack of clarity about the new LINks role and structure is a real cause for concern. If after detailed examination, senior MPs could not make sense of the government's proposals, then there must be a real question mark over whether the public will be able to make use of it.

“Importantly, however, we share the committee's concern over the effect of unnecessary reform on those essential volunteers who make the system work at a local level. As elsewhere in health, constant change has a corrosive effect, and where accompanied by curtailment of their powers, we fear that many volunteers will walk away under the new arrangements.”


The report, Patient and Public Involvement in the NHS, is available at

Articles from The BMJ are provided here courtesy of BMJ Publishing Group