ABSTRACT
This chapter compares two regimes of representation in terms of their operation, origins and impact. It reviews the evidence about Community Health Councils (CHCs) and health scrutiny and examines the inferences that may be drawn from this comparison. Until the reorganisation of the English National Health Service in 1974, the various institutions that administered it were also responsible for representing the public. Local authority health scrutiny came about as a direct, initially unintended result of the replacement in most local government authorities of the traditional system in which much decision making took place in functional executive committees in which all elected councillors participated. Many health overview and scrutiny committees (OSCs) initially struggled to link effectively to other involvement structures at a local level, though by 2005 they were beginning to build links with Patient and Public Involvement Forums (PPIFs).
