An Open Letter to the Secretary of State for Health and Social Care

Re: The Future of Public Voice and the Importance of Independent Advocacy

Dear Secretary of State,

We, the Chief Officers/Chairs of local Healthwatch services across England, are deeply concerned by the government’s proposal to bring public voice functions under the control of local authorities and NHS bodies – undermining the independence that makes public feedback effective.

For over a decade, Healthwatch has served as a trusted, impartial voice for members of the public, carers, and communities. Our statutory independence enables us to speak truth to power, challenge poor practice, and amplify the experiences of those too often unheard – particularly the most vulnerable and those with the most complex needs. We work constructively with local systems, but always with the freedom to raise concerns without fear or favour.

The Mid Staffordshire NHS Foundation Trust scandal stands as a stark reminder of the consequences of failing to listen. The Francis Inquiry made clear that independent scrutiny and public advocacy are essential. It also exposed the failure of local democratic scrutiny mechanisms, which lacked the expertise to detect serious failings – giving false reassurance to regulators.

Bringing public voice functions in-house risks creating a system where feedback is filtered, inconvenient truths are softened, and accountability is diluted. It sends the wrong message at a time when public trust in institutions must be rebuilt, not eroded.

We have countless examples of where people have chosen to share their experiences with local Healthwatch instead of providers, due to fear of repercussions, previous dismissal, or lack of access. People often tell us we are the first service to truly listen and the only one that follows up to ensure they receive the support needed.

Beyond gathering feedback, Healthwatch provides trusted, independent information and signposting to help people navigate complex health and care systems. We also respond to concerns from the public by carrying out Enter and View visits and conducting focused research that has resulted in real changes to local services. Our local knowledge and impartial advice are often the only support available to those struggling to access services – something not readily offered by the NHS or local authorities, nor covered in the new 10-Year Health Plan.

Since 1974 there has been continuous parliamentary support for independent public voice initiatives being able to hold services to account. Therefore, we urge you to reconsider this direction. Instead of dismantling independence, we should be strengthening it – ensuring every community has access to strong, well-resourced, and fearless local public voice initiatives that hold services to account and shape care that truly meets people’s needs.

We ask to meet with you to discuss why preserving independent public voice is essential. We remain committed to improving services – but cannot do so effectively if our independence is compromised.

Yours sincerely,

The Chief Officers/Chairs of 131 Local Healthwatch services