The preliminary findings of the Commission on Representing the Public Interest in the Health Service Inquiry are launched today at the annual conference of community health councils for England and Wales in Eastbourne.
The report's authors, concerned that more patients are resorting to the law to sort out complaints, say that relying on litigation is no way to ensure that the public has a voice in the NHS. Clinical negligence suits are estimated to stand at pounds 2.8bn and rising.
There is no democratic management of the NHS and all health authorities, trusts, regional offices and primary care groups are responsible to the Secretary of State for Health.
Community health councils, the government-funded patients' watchdogs that have funded the commission, are the only formal mechanism to deal with patients complaints or concerns, the report says.
"The NHS was founded to deliver free and equal access to health care and throughout its history it has commanded extraordinary public affection," said Will Hutton, chairman of the commission.
"However, there is now a gap opening up between what the NHS delivers and the expectations and needs of users. The signs of stress are there. Individuals are resorting to the courts for redress."