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Foundation hospitals are going to employ "democracy officers". They will attend clinics and quiz waiting patients on their participation in trust affairs. Trusts will be evaluated by the independent regulator on how many people vote for their governing boards.

That doesn't sound too outlandish, does it? But it's fiction. Yet the analogy serves a purpose. In health, the government has seemed keen to introduce a democratic element. But in social housing the doctrine of self-government has been even more insistent. The rhetoric speaks of choice, but the practice is enforced participation – and nowhere is the pressure greater than in ALMOs. Indeed, the "participation officers" I spoke of above are a reality for Hounslow Homes, the west London ALMO.

The government has stopped short of the obvious inducement – paying tenant reps on ALMO boards – but that probably has more to do with anxieties about the benefits system than principle.

So ALMOs have become a hotbed of housing democracy. But two key questions await definitive answers. One is whether there are enough households out there with the time, energy and perseverance to endure the detailed work of repairs and management. The other is whether tenant reps make for better management, defined either in terms of cost effectiveness or tenant satisfaction. It might seem to a civil servant that tenants are going to be happier with a plumber's work if the contract was let by a board containing one of their own; human nature says different.

ALMO boards are meant to be one-third tenants, one-third councillors and one-third independents. It will be interesting to see if the experiment ropes in more of that last category. Is the country really replete with people interested in housing, with a local connection but not social tenants, who are willing, unpaid, to do the ALMO job when they could get paid for being on an RSL board? Of course, whereas RSL tenants cannot change tenure except by buying, ALMO tenants could in theory stage a revolt aided by the Defend Council Housing legions and harass the board into petitioning the local authority to wind the ALMO up. As the government is finding in Iraq, democracy does not always go according to the script.

According to some inspections, tenants are still thirsting for more representation: read the Audit Commission survey of Hounslow Homes earlier this year and you are left with a sense of a surging demand for yet more estate meetings. The ALMO plan gives tenant involvement and "responsiveness" as one of its principal objectives and, beyond voting for the board, the Office of the Deputy Prime Minister and the Audit Commission are looking for signs of involvement. Officially recognised signs of tenant participation include newsletters, meetings, feedback sessions and the like. How much time are tenants supposed to devote to this activity?

The ALMO experiment rests on a strong assumption: that people who are often severely disadvantaged have the resources to make community self-government work; that there are enough tenants who are willing and able to run social housing. At a time when political commentators harp on the lack of trust between governed and governments and the precipitate decline in electoral participation, are ALMOs really going to buck this trend?