On the afternoon of 24 April in London, a meeting took place under the title Citizens and CCGs: Exploring our Future. I always thought this was Andrew Lansley's true genius – not the dismantling of the NHS itself, not the dark hold he has over David Cameron, but the phrase "clinical commissioning group", or more ingenious still, "consortia". If you can jam three words together that all take a bit of unpacking, that's often enough to make anybody normal walk away. Pretty soon it's become an acronym, the debating equivalent of an electric fence.

What was the purpose of this meeting? Which citizens, whose future, and what do CCGs do again, anyway? They are groups of GPs charged by the Health and Social Care Act with commissioning the medical services they decide their patients need. The room was mainly health professionals and the staff of 38 Degrees, the group that lobbied so hard against the act. The panel (I was chairing) comprised one member of a CCG, Dr David Wrigley; the leader of the Medical Practitioners' Union (in Unite), Dr Ron Singer; Dr Louise Irving, newly elected to the BMA council; and Roy Lilley, a founding member of the NHS Trust Federation (who told a droll story of his days running a hospital: if they ever needed to close a ward because they couldn't afford it, local councillors always objected. But they couldn't object to decorating the wards, so they'd just stick a bucket of paint in it and say it was closed for renovation).

Anyway, you're a patient; let's imagine you were against this act. What do you do? Wrigley suggested you talk to your GP in the carefree minutes at the end of your appointment, and everybody laughed. He then suggested getting involved in Healthwatch, which takes over from Local Involvement Networks, officially (LINks) in October. If you want to feel so defeated that you put one of your eyes out, you can Google Healthwatch – the Department of Health and local authorities talk a lot about community engagement, focus groups, facilitated discussions, cascading knowledge, empowerment. I can't see anything that tells you which meeting you would have needed to go to if you lived in Surrey and didn't want a £500m health services contract delivered to Virgin before the act's ink was even dry.

However (deep breath), we don't all live in Surrey; considering how many medical professionals opposed this bill, some CCGs are bound to be progressive, and committed to the NHS as a public institution. OK, it's not immediately obvious how a concerned citizen would get anywhere near Healthwatch, let alone influence its position, let alone how that position will influence a CCG's decision. But just because it's not obvious doesn't mean it will never happen.

Wrigley then mentioned the health and wellbeing boards, which will have a statutory role from next April. They mainly comprise workers from within the health service, social services and third sector, but it's mandated that they should have one locally elected representative – it doesn't say they can't have two, or 10. Of course there will be frustrations, intransigent bureaucrats, privatising zealots, people whose power simply exceeds that of the "community". But in many areas the clinical commissioners will be receptive to community concerns. They'll have opposed the bill themselves in the first place. So this is a bad time to shut up and go home, either literally or virtually. All this apparatus will be designed as we go along, and it won't be designed by people who have left the conversation.

What else can we do, between us? We can club together to get legal support for CCGs, so if they want to award contracts to NHS providers rather than private companies their decisions will be "judicial review-proof" (if you want to get so angry that you put out your other eye, consider that Virgin – or rather, Assura Medical, in which it has a 75% stake – lodged a complaint before the act was even passed against York Hospitals for "predatory pricing". Because they weren't trying to make a profit, they were just trying to treat people who were ill – so it wasn't fair on the private companies tendering for the business).

Those were all useful things to think about, but the real starting point for the meeting had happened earlier in the day round the corner, where CCGs had been invited to another event, jointly sponsored by United Healthcare and Capita. No decisions were made, it was just, you know, a message from the sponsors. "Hi. Look at our peanuts and other largesse." Members of 38 Degrees chipped in a quid for a rival meeting, a message from the other sponsors, and raised £65,000 in 48 hours (they didn't spend it all on wine; they're going to do other events in Birmingham and Chester).

And this again may leave you optimistic or pessimistic, depending on your underlying mood health. It is never great, is it, when you have to stage a guerrilla cocktail party to remind the world that United Health and Capita do not own the NHS, they had no hand in its creation, their only care for it is financial and just because they have the cash doesn't make them the grownups. On the other hand, it is increasingly clear that anybody who thinks the fight for the NHS finished with the passage of the bill ain't seen nothing.

Twitter: @zoesqwilliams