Community health council leaders are demanding changes in the law and new guidance on openness to stop health authorities going behind closed doors to vote through service cutbacks.
Health secretary Frank Dobson has been urged to investigate the operations of one London HA, whose last meeting was boycotted by local CHCs because 'important business' affecting the health of local people was decided in private.
CHCs claim HAs are being encouraged to discuss important business in closed session by NHS Executive regional offices.
The NHS Executive told the Journal that CHCs' concerns are being investigated, but added 'it has been made clear to all HAs that they should hold meetings in public' unless particularly sensitive items that could harm the public or staff were to be discussed.
The issue was raised shortly before Christmas after several CHCs sought legal advice from the Association of CHCs for England and Wales.
Legal officer Marion Chester wrote to the Executive demanding changes in current legislation to bring HAs in line with other public bodies so that the range of issues they can consider in private would be clearly defined.
Meanwhile, there should be 'clear guidance' to all health bodies on their existing legal obligations, 'including the requirement that all HA board meetings be held in public'.
Ms Chester asked that new guidance should also spell out that any decision to go into private session should be considered in the 'light of this government's commitment to openness' and contain a reminder that boards must pass a resolution to exclude press and public before going into private session.
She said: 'There is evidence that HAs are going into private session when they should not, but there are problems with the legislation because it gives them a broad discretion. We believe new guidance is needed, not just for HAs but for regional offices who seem to be encouraging HAs to breach the law.'
Some London CHCs say they are alarmed that regional offices have told HAs not to discuss in public their response to the independent London review, whose report on the capital's future health services is being studied by ministers.
That point has been taken up in letters to Mr Dobson by the two CHCs in the Redbridge and Waltham Forest HA area, where concern about what is discussed in private has been raised by local MPs.
Waltham Forest CHC chair Malcolm Wilders has asked Mr Dobson to set up a 'ministerial investigation' into the HA's operations after a series of secret board meetings led to proposals for pounds14m of cuts affecting mental health, drugs and alcohol, and community nursing services.
HA spokesman Martin Prestage said its solicitors had advised that the HA would not be acting illegally if it met in private session to discuss draft proposals. North Thames regional office said it was looking into issues raised by the two local CHCs.
Redbridge CHC chief officer Dominic Ford has also written to Mr Dobson raising concerns about the HA holding private sessions. His letter welcomed the NHS white paper's 'strictures against secrecy' and Mr Dobson's directive that decision-making should be transparent. But Mr Ford said that local CHCs wondered, 'how far HAs are willing to abide by this and how far regional offices will direct HAs to breach the legislation and the commitment to openness in the NHS.'
A 'modern, dependable NHS must be based on public trust', Mr Ford wrote. 'Secretive practices of the past must be cast aside. If this is to happen, all parties - HAs, trusts and regional offices - must evince a commitment to openness and accountability and a willingness to abide by the law.'