Patients are to be granted power to petition for better local health services under proposals put forward by ministers. The petition must be signed by 1% of the population to initiate a formal response from primary care trusts that commission local services.
This is mainly seen as an attempt to give the public a "more powerful voice". Ministers have also said firms were being invited to run PCT services in an extension of private involvement in the NHS.
The Official Journal of the European Union ran an advertisement two weeks ago for private firms to take control of PCTs, which comprise 80% of the NHS budget, to buy in services from hospitals, community services and GPs.
This would enable the PCTs to "pick and mix" the services they want to outsource so that they can take advantage of specialist skills that the private sector has such as handing over responsibility for data collecting, procurement and analysis. PCT boards would still remain accountable for the services.
According to Health Secretary Patricia Hewitt this would mean that the taxpayer gets "better value for money", while the quality of care will improve.
However the medical profession still remains against the proposal to give private firms an opportunity to get their hands on local NHS budgets, as it would mean that firms would be involved in commissioning services and providing care, creating a potential conflict of interest.
Alex Nunns, of anti-private campaign group Keep Our NHS Public said, "As we have found out with PFI schemes, private managers can run rings round public sector managers."
The move to give patients more power over local services also met with criticism.
The present proposal has ensured that a petition signed by 1% of the local population could demand changes to any NHS service if they were unhappy with the standards of care being provided. In addition if it was a specialist service, a response would be triggered if a tenth of users signing up.
Patient power would be further boosted through setting up patient bodies called Local Involvement Networks (LINKs) to take on the responsibilities of patient forums. Each NHS trust will have a forum to monitor and advise local services.
Ms Hewitt said: "It is about giving patients a more powerful voice in how their NHS is run."