Top health charities have banded together to call for changes to controversial plans for healthcare that would see patients given more say over how their area is run.
Eight groups have told the Government that its intention to make GPs responsible for commissioning NHS services needs "crucial changes" to make sure they are "answerable to everyone it serves".
The Health and Social Care Bill would see groups of GPs responsible for £80 billion, but the health charities - representing millions of people collectively - said plans to hold them to account are "weak". They want budgets and resourcing choices checked by an elected official in each area.
The health groups that wrote to The Times newspaper include The British Heart Foundation, Breakthrough Breast Cancer, the Alzheimer's Society and Asthma UK.
They said: "We support the Government's aim to put patient involvement and democratic accountability at the heart of the health system. However there is a gap between rhetoric and reality. The reforms will place £80 billion of the NHS budget into the hands of GPs, but plans to make GP consortia accountable to the public are far too weak.
"The plans will allow local authorities to replace existing democratically elected overview and scrutiny committees with their own systems."
The letter went on: "Greater patient and public involvement leads to better care and more efficient services yet the proposed reforms do little to give patients a stronger voice at a local level. The new local HealthWatch bodies described in the Bill will not have the powers or resources to ensure that patients have a say in their local health services.
"If they are to serve a meaningful purpose they must be significantly strengthened."
Currently, primary care trusts and strategic health authorities commission services for patients. The GP consortia are due to take over in 2013 and 141 have already volunteered to test the system before then, covering more than half of England.
The Department of Health said the charities had raised some "constructive" points but insisted service users and the public would have "real clout" over their local NHS after the reforms.
A spokesman said: "We will work together to ensure the Bill, which is in its early stages, delivers the reality of improved patient involvement.
"Our modernisation plans would give patients, local authorities and the public, real clout over the shape of NHS services. For example, elected individuals will shape the provision of local services and patient groups will have power through HealthWatch to trigger inspections of NHS services."
The letter is also signed by the Stroke Association, Diabetes UK, Rethink and National Voices.
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