Healthwatch Oxfordshire is the only independent watchdog for health and care services in the county and has a statutory duty to hold those who run the services to account. It does so by carrying out reviews of services and publishing results and recommendations, to which the authorities are required to respond.

Here Healthwatch Oxfordshire chairman Eddie Duller OBE gives his personal opinion on why the public should be involved in planning services much earlier.

Speak up. Taxpayers who provide the cash for the free at the point of delivery health services run by family doctors, hospital and other trusts, have the right to help shape the delivery of the services through consultation when changes occur or are planned.

But in reality they are more often than not given a “fait accompli” and simply asked to give their opinion for or against a proposition already worked out by unelected officers in the case of the health service, or in some cases not given the opportunity to give their point of view at all.

It is a similar scenario for social care services, which in the main are run by the elected Oxfordshire County Council, but which are not all free at the point of delivery.

I think it is about time that is changed.

There has been a lot said about the sensible and obvious need to join up health services with social care, which can lead to people being looked after better nearer their homes and reduce the strain on hospitals.

However, those conversations and proposals being made by a non-elected transformation council do not include any public representation.

The lack of early consultation does not end there.

One of the most disappointing attempts at getting the paying public involved in helping to shape services is the patients participation groups that were able to start up under a Government initiative.

This idea is to give patients a channel through which they can suggest ways in which our hard-worked GPs can improve their service as well as supporting them in other ways.

The Government gave GPs money to set up their groups in each practice, being run by the patients.

But only about 10 to 15 per cent of GP practices in the county have embraced this idea in a meaningful way.

I have seen some brilliant examples of this working, in particular in Benson and in the Barton area of Oxford, where patients have organised events to get people involved in healthier lifestyles and so reduce the burden on over-worked family doctors, who are the most important link between the public and the health and social care services.

In most cases, however, the GPs have shied away from patient-led groups and in some cases set up “virtual participation groups” led by the practice managers, which give the practices control of what may be discussed. Some have done nothing at all.

The answer to this is mainly with the patients themselves, and that is why I am saying speak up.

Ask your practice manager about your participation group and persuade them to publicise it on their surgery noticeboards. And join in because this is an initiative which can result in positive results for both patients and doctors.

On a more strategic plane, those planning the biggest shake-up in health and social care services in the last 40 years, such as the transformation council, should be appointing representatives of the general public now, and not facing them with a straight choice which may have to be adapted at a future date.

The revolution is becoming more complex by the day.

Originally Oxfordshire County Council told the Government it was interested in running services, including a joined up health and social care service, as part of the Government’s devolution plans.

Now the district councils, who are closer to the electorate than the county council, have got together to put in a rival bid to do the same thing.

In between, the Oxfordshire Clinical Commissioning Group, which pays for most of the health services in the county, has come up with a realistic plan to join up health and social care in the county.

It is no wonder the public is confused. As the authorities are only publishing their own point of view, I will be trying to make sure we have an explanatory over-view of the changing action explaining how the public is affected on our website at healthwatchoxfordshire.co.uk, where you can see other examples of our work on behalf of the public.

In the midst of local change the Government has cut funding to the NHS watchdog, the Care Quality Commission, by 25 per cent with the result that there will be fewer inspections of hospitals and other care settings.

That is not good news.

The county council has cut Healthwatch Oxfordshire funding by 30 per cent, which means we will be struggling to repeat the volume of work we carried out last year under our statutory powers without raising extra funding. That is also not good news.

We will be as vigilant as ever and put a special effort into getting the public to speak up for itself and to press the authorities to allow the public to do so.