Patricia Hewitt: I've always argued for electoral reform

A voting system that feels unfair does little to reconnect people

But isn't health inequalities, more money for the NHS and better services for hard-to-reach and disadvantaged communities "political"?

This health worker's remark reminded me just how much we have to do to reconnect people with politics. But we face a paradox here. Everywhere, people are involved with "small-p" politics, from tenants' and residents' associations or a campaign for a pedestrian crossing, right through to international environmental groups and make poverty history.

Yet there is a chasm between "small-p" politics, and people's enthusiasm for a collective experience, and the "big-p" politics of the major political parties.

Why? The political system is partly to blame. A voting system that feels unfair does little to reconnect people. Yes, Labour benefits when a minority of votes is rewarded by a majority of seats - but none of us can be comfortable when nearly four out of 10 people don't vote at all. I have always argued for electoral reform - provided we keep the vital link between MP and constituency - as part of a wider political settlement, and I welcome The Independent's determination to keep the issue on the public agenda.

But Britain's political malaise runs deeper than the voting system. Modern culture, with its thirst for the real, the authentic and the immediate, makes representative democracy appear indirect, formal, and unauthentic. The individual - whether a Jamie Oliver or a patient given inadequate treatment - will always trump the politician who seems to embody "the system". Giuliano Amato, a former Italian prime minister, expressed the frustration many of us feel when he confronted the anti-globalisation protesters claiming to speak for "the people" against the politicians. He put the simple question to them: "How many people elected you?"

Partly it is a factor of the decline of deference, where a local councillor no longer commands the respect of the alderman of yesteryear. Partly it is the fault of a male-dominated macho adversarial political culture.

So what do we do about it?

Even in a country the size of Britain, we need to recapture something of the spirit of Athenian direct democracy. Citizens' juries in local government, patients' assemblies and initiatives such as the citizen's council run by the National Institute for Health and Clinical Excellence (Nice) suggest a way forward. At the Department of Health we have started a process of deliberative democracy, involving citizens in designing the future of community health and care services. Their views will be the basis for a white paper at the end of the year - and each participant will hear from me how we are acting on their ideas. Deliberative democracy has proved highly successful in the United States where the America Speaks initiative has captured the imagination of many communities - helped by local and regional television willing to report in depth the local meetings, free from the kind of cynicism we could expect in the UK.

In the Labour Party we need to ask ourselves some tough questions about how we operate. Instead of trying to shoe-horn people into our structures of local branches, general committees, and endless leaflet rounds, we must learn how to provide a positive individual and collective experience for people who want to make a difference. Every community has them. What they don't want is to become embroiled in boring meetings, internal faction-fighting or party political point-scoring. What they want is to see a difference on their streets and estates.

I know I'm the not the only MP who found at the general election that, while several party members were unwilling to campaign, even more non-members - usually from community groups - were out on the doorsteps helping to win the argument and get out the vote. The party "activists" were not necessarily active: but the community activists were.

This reality has prompted Labour to launch its new supporters' network to tap into this latent support from people who wish us well, don't want the Tories back, but don't like traditional party activities. This should be start of a new style of "retail" politics, which treats people as individuals and brings them together to get results, rather than wholesale politics which treats people as a mass market. I hope the woman I met at the NHS walk-in centre feels that this kind of politics is for her.

Patricia Hewitt, MP, is Secretary of State for Health