Radical plans to reform the healthcare system must be amended to give patients a stronger say over their local services, a group of leading health charities said today.
The eight organisations, which represent millions of patients, called on the Government to make "crucial changes" to the Health and Social Care Bill, "to ensure the NHS will be answerable to everyone it serves".
They described plans to make a network of GP commissioning consortia - which will be responsible for £80 billion of the health service budget - accountable to the public as "weak".
They demanded that democratically elected representatives are used to scrutinise decisions and budget management at a local level.
In a letter to The Times, the charities, which include the Alzheimer's Society, Asthma UK, The British Heart Foundation and Breakthrough Breast Cancer, 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 continued: "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."
Under the reforms, GPs will take control of commissioning services for patients. Strategic health authorities and primary care trusts (PCTs), which currently commission services, will be abolished.
So far, 141 GP consortia, serving more than half of the population of England, have now signed up as "pathfinders" to pilot the new arrangements ahead of their planned implementation in 2013.
The Department of Health said it welcomed the letter, which had raised a number of "constructive" points.
However, it claimed the proposed reforms would give patients and the public "real clout" over the shape of the health services they received.
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 eight charities who signed the letter are the Alzheimer's Society, Asthma UK, Breakthrough Breast Cancer, Diabetes UK, National Voices, Rethink, the British Hearth Foundation and the Stroke Association.
The proposed health reforms have come under intense criticism since they were announced by Health Secretary Andrew Lansley.
The heads of six health unions, including the British Medical Association and the Royal College of Nursing, voiced "extreme concerns" that plans to create greater commercial competition between the NHS and private companies within the health service could lead to lower standards of care.
The NHS Confederation - which represents the bulk of health service organisations, such as hospitals and primary care trusts - described the proposed transfer of commissioning power to GPs as "extraordinarily risky", warning of closed hospitals and treatment rationing.