Health Trusts were set up by the Tory government in about 1990, to replace the locally- based, but oligarchic, Community Health Councils with a more commercially- oriented management. The idea was to expedite the NHS internal market, which most independent observers believe was an attempt to privatise the NHS by the back door.

The lay members of the Trust will have minimal powers- their purpose is to give a semblance of democratic control, without relinquishing any real power to them. The power remains in the hands of the permanent management, who often receive silly salaries (six figures and onwards) and see the trust mainly as their own property. This is in line with the real purpose of the NHS under New Labour, which is to transfer large amounts of money from the public pocket to private companies. Any health care that happens on the way is a welcome, if non- essential, byproduct.

As a lay member, you will be subject to non- disclosure regulations which mean that should you find any details of the massive scams going on, you will be unable to disclose anything about it on pain of prosecution. You will however be in the firing line should any disaster (superbugs, abuse of elderly patients, harvesting of organs from not- quite- dead children, to name a few imaginary examples) occur.

In short, if you want to influence the government's running of your local NHS, you'd be better off standing on a soapbox in the local park- unless you are a multibillionaire businessman of course.