This chapter examines attempts to represent the patient-consumer during the 1970s, focusing particularly on the part played by the Community Health Councils (CHCs). It suggests that a lack of clarity about what patient-consumer representation was, who was being represented, how this could best be achieved, and its ability to have any impact on health services, beset the CHCs from the outset. Uncertainty about the meaning and purpose of patient representation manifested itself in conflicting views about the CHCs’ role and effectiveness that impinged upon their ability to represent patients’ interests. Moreover, the CHCs had to contend with better established and more powerful interest groups within health care such as health professionals and health service administrators. Beginning with the origins of the CHCs, moving on to consider the meanings of representation, and then assessing the effectiveness of the councils, this chapter will demonstrate that having a voice and being heard were not the same thing.
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