Select Committee on Health Written Evidence

135. Evidence submitted by Len Roberts (PPI 74)

How Should the LINks be Designed?


  The new system of LINks, as so far notified, has the capacity to either strengthen or weaken patient and public involvement in the NHS and the Social Services. Which way it goes will depend on the way the scheme is structured, its statutory powers, the extent to which it is professionally supported, and how it is promulgated.

Detailed Statement

  1.  An amorphous community network may act as a useful information resource for the Authorities, but unless it has a strong central Group of independent volunteers able to monitor services and enter directly into evidence-based debate, the public voice will be neutered. The current Patient Forums have developed such capacities: for example most Forums carry out formal and informal inspections, many Forum Chairs are non-voting members of PCT Boards, and Forum members join NHS committees and working groups. Their legitimacy to put a Patient Forum view is accepted.

  2.  The importance of a clear, cohesive and independent patient and public voice alongside that of clinicians, managers and financiers will be of critical importance as the service goes through a period of fundamental change.

  3.  Sometimes Patient Forums may not been sufficiently in contact with, or representative of, the wider range of voluntary and community groups in their areas. A LINks scheme with a strong centre will strengthen the PPI system. A LINks system without a strong centre, will be a PPI system neutered.

  4.  Everything depends therefore on the structuring. There needs to be a strong central body in each individual area, made up of independent volunteers, with the legal authority to monitor services, be consulted and listened to on service issues and changes, and with the capacity to raise issues with the County OSC, and in any other way.

  5.  LINks should have a formal capacity in its relationship with the PCT. One possible way of structuring this would be for each PCT to have its own Patient Council drawn from LINks. LINks should also have formal rights in relation to the Strategic Health Authority and the Department of Health.

  6.  Where services are being provided at the County level, it should be remembered that patients and the public relate best to services in their own home areas. There is a danger of too much NHS centralisation. Within a County level PCT, there should be strong localities with their own budgets and management to which Locality Links can relate.

  7.  Weaknesses in the current Patient Forum system are often due to a failure to provide strong professional support. Volunteers have been asked to do a big job. They are not paid, and that is right. They do, however, have to spend a lot of time on computers, printing off documents, using the phone, travelling -and so on. They should receive a small but realistic allowance. If they are in work, they should (like Councillors) be entitled to a Financial Loss Allowance. They should not be expected to do administrative, managerial or technical research tasks. Some reports (for example of inspections) should be drafted by staff, for agreement. The bodies LINKS will be relating to have strong administrative support: statutory Patient Bodies should be entitled to no less.

  8.  LINks must have inspection powers to monitor effectively. Those carrying them out should be properly trained and professionally supported. They should not, however, be hedged in by detailed central regulations.

  9.  PPI has to look two ways: to be truly connected to its communities and equally to the services it monitors and be fully accepted as legitimate by both. It has to become part of the consciousness of the public and the staff, but his will not happen as by nature. LINks will need to be "branded"—and as a start have a name more descriptive of what it is about. The new brand should be publicised through the national media.

  10.  Patient and Public Involvement is a brave venture in strengthening democracy. The key issue is whether Parliament and the Government are serious in seeking a more civic society. If so, they could be more encouraging to volunteers. But above all they must provide the powers, and will the means.

Len Roberts

Chair, East Surrey Patient Group, a part of the Surrey Patients Forum

(comments are made as an individual)

9 January 2007

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