The announcements this week on improving care and patient dignity in the NHS are welcome, but the one set of people that seem to me to be missing from the framework is the public.

There are over two million members of NHS Foundation Trusts. They ought to be a bedrock on which a participatory NHS can be built – after all medical professionals are expert on medical treatment, but patients are expert on what care and dignity feels like when receiving that treatment.

It is ten years ago to this week that the Act creating Foundation Trusts came into force. I was involved at the time, advising on the framework for participation. So I have put together a short report, Ten Years After, reflecting on progress over that time.

In reality, the role of membership in Foundation Trusts, as they have widened, has become more token. There are some exceptions, not least in the mental health field, just as there are exceptional health mutuals outside of the NHS. Worldwide, 300 million people are covered by health coops and mutuals. Membership is something which all mutuals have to focus on and I set out some practical recommendations which could help to restore some of the more active role for members that was core to the original vision.

There is more to do to create a health service based on genuine mutuality between the professionals and the public.

Ed Mayo is Secretary General of Co-operatives UK. This post originally appeared in his personal blog