"Health services is one of those areas where the whole population has a particular knowledge and experience. Everyone has an opinion on how those services are made available to them and delivered.

Community Health Councils were established as an independent body by Parliament to keep health services under review and to represent the interests of the public in all aspects of the NHS.

There is a duty upon the health services to interact with the population with a view to matching demand against need. Health services are not provided within a vacuum but is there as a fundamental part of social interaction. But in order to plan a future and to actually take the population along with those decisions, people need to be informed of basic statistical information on demography, etc, limits on resources and a projected view of expert opinion on future need.

It is then within that process that we have the greater social interaction with the public and the consequent conflict and confrontations on interpretation. Should we have hospitals in every village or every town? Should there be specialised units close to the population or central areas? What is the cost involved? Do these services become obsolete or obsolescent? Are we geared to change? Do we want to maintain the status quo or move forward in a more progressive way?

A whole complexity of consultative papers are being made available for response. The Community Health Council is the ready source to reflect the public view.

Brecknock and Radnor CHC is made up of 20 volunteers members who live and work in the area. There is a geographical spread of members with a balance of political view and socio-economic groupings. In addition the CHC has health focus groups within communities all with 20 plus members and representing a cross section of their community.

Through this process opinion is fed from the grass roots of society by the medium of meetings, interaction, reaction and pro-activity into Local Health Board, health service providers and Government. This medium of opinion flows from such issues as cutting of toe nails to homecare, GP services, local community hospitals and tertiary provision. The dynamics of this process boosts CHC membership and offers the opportunity for public opinion, through those representatives through the structure of the organisation.The voice of several thousand people are heard via this process.

It also acts as a medium by which information cascades from Government and the Local Health Board and Trusts to the population itself. To help the CHC and its organisation there is a very limited office staff to support the activity, which includes a Complaints Advocate, who gives a free and independent advocacy service to assist patients (or their representatives) in making a complaint under the NHS complaints procedure. This covers hospital care, GPs, dentists, opticians and pharmacists.

This help can include: • Offering advice - how to complain, who to complain to etc. • Explaining the complaints procedure (which some may find confusing or bureaucratic) • Doing research • Writing letters • Providing support at meetings.

The level of support depends on the needs of the individual. The service is offered in a friendly, confidential manner and encourages the NHS to learn from the patients experience and improve services.

We also have Mental Health Advocates who provide a comprehensive, independent, confidential, impartial and free advocacy service for people in Powys who have serious mental health problems. The advocates can:

1 Provide information and advice to patients on rights under the Mental Health and Human Rights Acts.

2 Accompany, assist, support and represent the patient's views at case conferences, managers hearings and tribunals if the patient refuses or cannot afford legal representation.

3 Accompany, support and represent the patient's view at care plan/discharge meetings.

4 Advise patients on rights to information concerning treatments and medication available

5 Help patients to complete forms such as housing benefits and others appropriate to their individual needs.

One must take responsibility for one's own health. At the end of the day health services can only do so much to support good health. We must accept the prime responsibility ourselves - good diet, exercise, healthy life style, etc. The body is but a magnificent machine that needs to be looked after, serviced regularly and pampered, and then with luck and support from the NHS we can enjoy a full and active long life.

We believe there is no better way of seeing democracy in action for the people and with the people. The ownership firmly implanted in the hands of the people and patients."

Article written by Bryn Williams