Health elections pass crunch vote

Ministers said accountability must be central to the NHS

Controversial plans for directly elected health boards in Scotland have passed their first hurdle.

MSPs voted in principle for legislation to introduce trial schemes in two health board areas.

Five of Scotland's NHS authorities have opposed the plans, while a further five have expressed strong concern.

Doctors' group the BMA is also opposed, but Health Secretary Nicola Sturgeon said the public often felt "shut out" of decision-making in the NHS.

One of the earliest acts of the SNP in government was to reverse decisions by the previous administration to close accident and emergency units at Ayr hospital and Monklands in Lanarkshire, which had caused a local outcry.

Boards 'unresponsive'

"Many people - in all parts of Scotland - believe that there is a real democratic deficit in the operation of our health boards," Ms Sturgeon told MSPs.

"Too often the public feel shut out of the big decisions - big decisions accounting for significant sums of public money - that are taken by boards on a daily basis.

"And sometimes that exclusion from the decision-making process leads to a deep-seated alienation from the decisions that are reached."

Ministers also agreed to a Liberal Democrat plea to pilot alternatives to elections.

The party's health spokesman, Ross Finnie, said Holyrood's health committee had found "considerable disquiet" in the way health boards were discharging their functions.

"There certainly were views that they were not responsive, there were views that they were not clear about how they engaged or what they were to do about engagement," he said.

Heath board elections would be held every four years under PR

Labour's Cathy Jamieson said allowing the public voice to be heard must be at the heart of the decision-making process - but stressed the sentiment must count for all issues, not just controversial ones.

And she said elections must be properly funded, without hitting frontline services.

Tory health spokeswoman Mary Scanlon said objections to the idea of health board elections could not be ignored, but agreed there was more support for piloting them.

The two pilot elections would be paid for by central government at a cost of