The government has published its NHS mandate with the accompanying consultation response. You may remember this consultation process. It was the invitation to participate that got lost in the post.

Campaigning groups 38 degrees and OurNHS highlighted the fact that the deadline for the public to comment on the proposed mandate was fast approaching but no one seemed to know about it. Then, I wrote a piece for the Guardian and you shared, commented and crashed the Department of Health (DH) website. There had been 900 responses before the piece, and by the close of play four days later the figure had reached nearly 130,000.

Healthwatch England confirms that the Guardian article led to a dramatic influx of responses by the public. No one seems more surprised by the scale of the response than the DH itself. Its report says: “We have consulted publicly twice on the mandate in the past and on both occasions attracted around 300 responses with slightly more than half originating from members of the public and the rest from institutions.”

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This time was different. “This year we attracted a similar number of responses from organisations. The public response, however, was significantly higher than in the past, with around 127,400 responses received by the close of the consultation.” And it acknowledge that the system was overwhelmed. “We would like to thank respondents for their patience while we adapted the routes to respond: increasing the capacity of the consultation inbox and setting up a new a web-based form on Citizen Space to make responding easier.” It reminds me of when you send out summer party invitations confident that most people are away and then, to your horror, find they’ve all turned up.

So what did we say in our responses? “The main issues raised by members of the public were around the extent of private sector involvement in NHS services, whether the NHS is sufficiently well funded and the impact of seven-day services,” says the report. People want less private sector involvement, more funding and aren’t bothered about the focus on seven-day-a-week care.

The mandate seeks to reassure us. The NHS is to remain comprehensive and free at the point of use. It dare not mess with that. Fiscal challenges are to be managed by “changing the way services are delivered and keeping people well and independent for longer”. As if there are easy, cheap and effective ways of doing that.

And in response to concerns about the private sector, we are assured: “This is not an agenda for privatisation.” And in the next sentence, “The NHS will continue to harness the capacity of the private and third sectors where they are best placed to deliver high quality services for NHS patients.” I’m definitely missing the nuance on that one.

There’s another lovely example of acknowledging the responses, only to override them politely but firmly. “Fewer than 3% of responses that mentioned seven-day services were supportive. The main concerns were that seven-day services are not necessary, that they are not affordable and that they will put too much strain on staff who already work very hard.” And the response? “We are committed to ensuring that people who need urgent and emergency hospital care receive the same high quality of care seven days a week.” Fair enough. 24/7 care does already exist but there’s clearly room for improvement. The point is that it asked for our opinion and then disregarded it.

Let’s be fair. There’s a lot of good stuff in the mandate. Healthwatch England welcomes the way in which patients’ complaints are to be used to bring about change. There’s a commitment to improving the overall health of people with mental health problems, learning disabilities and autism, and the wellbeing of children. The government apparently plans to invest an additional £10bn in the NHS between now and 2020. And respect where it’s due: the consultation response report is candid and clear.

But this is my worry. They asked our opinion (sort of) and noted our concerns. Some changes have been made to the mandate as a result of feedback. But on the key concerns about funding and privatisation, there is no substantial shift. They can certainly hear us, but is anyone listening?

• This article was amended on 21 December 2015. An earlier version referred to Healthwatch UK, rather than Healthwatch England.

