NHS elections to pass crunch vote

Ministers said accountability must be central to the NHS

Plans to trial health board elections in Scotland are likely to pass their first parliamentary hurdle, despite strong opposition from health boards.

Health Secretary Nicola Sturgeon said they were needed to improve public confidence in the health service.

But five of Scotland's NHS authorities have opposed the plans, with a further five expressing strong concern.

Rival parties are expected to back pilots in principle, with the proviso of another vote to roll out the scheme.

Ms Sturgeon said she was determined to end a "democratic deficit" and ensure the views of communities were properly considered when health boards were making decisions about services.

"Accountability, transparency and responsiveness must be at the very heart of public sector decision-making and direct elections to health boards are an obvious and logical way of achieving this," she said.

Further vote

Five of Scotland's 14 health authorities - Highland, Tayside, Ayrshire and Arran, Lothian and Grampian - have opposed direct health board elections outright.

A further five - Shetland, Forth Valley, Lanarkshire, Greater Glasgow and Orkney - have expressed doubts about the plans.

They include concerns about the "politicisation" of boards and being flooded with single-issue candidates with no interest in overall policy.

Critics also pointed out that councillors already sat on health boards, which were accountable to ministers and parliament.

The government hopes to pilot health board elections for at least two years before a decision to roll them out Scotland-wide is taken.

Opposition parties are likely to support that position, but say there must be a further vote at Holyrood before that could go ahead.

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.

Health board elections would cost nearly