Don’t Silence the Patient Voice: Why Abolishing Healthwatch is a Mistake

Abolishing local Healthwatch is NOT a foregone conclusion – now is the time for MPs and national and local allies to defend independent public voice in health and care

The NHS 10 year plan flags that the Government intends to abolish local Healthwatch. This is part of a wider move away from independent public voice – replacing it with individual NHS apps and a reliance on NHS providers and commissioners doing public involvement better.

You can read my initial critique of this proposal here.

In order to abolish local Healthwatch – an Act will need to be passed in Parliament.

This means that Local Healthwatch will continue to exist for at least another year – possibly two.

You can see a probable timeline here – notice that it is at least a year long.

We live in a democracy

Lobbying to change legislation is part of the democratic process.

It is the case that a number of local Healthwatch are talking to local leaders including MPs and local authorities to gather allies to seek to change this proposal and identify alternatives if the Act is passed  unchanged.

Isn’t there good evidence that local Healthwatch should be abolished?

Actually the evidence base for this decision is very thin. Here is a summary of the rationale from the Penny Dash review for DHSC on patient safety (2025) and parallel rebuttals from me highlighting analytical weaknesses.

There is a bit more detail to download here.

The rationale for abolishing local Healthwatch is weak. Abolishing it weakens independence and public voice, reduces equity and removes statutory accountability mechanisms.

Who cares that local Healthwatch is being abolished?

There is an online petition organised by local Healthwatch here.

In addition to this Sian Berry MP has tabled an early day motion in response to the abolition proposal.

There is also a second early day motion launched by the Liberal Democrats here.

Many reputable organisations have expressed considerable concern about the abolition of local Healthwatch.

• The King’s Fund — Long read unpicks the plan and flags risks to independent patient voice; explicitly notes the plan would abolish Healthwatch England.
  Nuffield Trust — Questions deliverability and capacity, warning that over‑centralisation and unclear accountability could undermine aims.
  The Health Foundation — Analysis argues the plan’s policy mix lacks clarity and coherence, risking distraction from core improvement and equity.
• NHS Confederation — Explains what’s in the plan and highlights practical risks during transition, including governance and oversight gaps.
  National Voices — Umbrella body for charities warns against weakening patient and public involvement structures.
  Patients Association — States closure would remove a vital, independent route for people to be heard and for services to learn.
  BMJ (News) — Reports patient leaders’ concerns that replacing independent safety bodies and patient‑voice mechanisms could undermine safety.

More detail is available here.

There are so many expressions of concern out there – here a just a few:

• Lucy Nicholls
• Claire Ainsworth – BBC SouthWest
• The Care Forum
• Samantha Botsford

Why is there no national campaign then?

This is probably because Healthwatch England has largely accepted that the proposals in the legislation will become law. In other words it is doing its best to close local Healthwatch in an orderly way.

It is interesting to see that the current Chief Executive of Healthwatch England is now a non Exec Director of NHS England. NHS England will of course NOT be publicly opposing any of the actions in the 10 year plan!

In fairness to Healthwatch England it is part of the Care Quality Commission and is therefore constrained with regard to lobbying in a way that independent local Healthwatch are not.

However a quick analysis of the Healthwatch England approach shows that while constrained by its legislative position it has also failed to utilise its strategic position.

Healthwatch England’s statutory design inside the CQC explains why it did not front a national campaign or petition: it lacks formal campaigning powers and is structurally dependent on the Department of Health and Social Care.

However, this does not explain the absence of strong, evidence-based interventions. HWE could have:

• Published authoritative independence and accountability analyses;
• Highlighted statutory powers (Enter & View) that would be lost;
• 
Coordinated national media stories and external coalition support;
• Equipped MPs, Peers and the local Healthwatch network with amendment packs and briefings.
• 

In short, the weakness of HWE’s response is only partly due to its legal constraints. The greater issue is a lack of strategic leadership and failure to exploit the tools available within its remit. This has left the defence of independent Local Healthwatch largely to local bodies and external allies.
• There is more detail in this short briefing here

The abolition of local Healthwatch is not a forgone conclusion. In my view it is very unfortunate that Healthwatch England has accepted the 10 year plan proposal and is currently talking to key players such as the Local Government Association and DCLG about the wind down of local Healthwatch rather than about how they can be defended.

As citizens and independent organisations we have the right to lobby government and to challenge proposed legislative change.

Now is not the time to be scurrying around trying to tidy everything up with local government (the commissioners) this should be after/if the legislation has been passed.

There is still plenty of time to call for a rethink.

It is clear that Healthwatch England does not represent the views of local Healthwatch who are independent local organisations. Many are are pursuing a course of action that is different to that of Healthwatch England.

This is more than the survival of local Healthwatch – this is about arguing for a local based, independent voice which supports local people collectively to raise concerns about their health and care services.

WHAT DO YOU THINK?