Scottish health councils fear their independence and their credibility with patients could be undermined by government attempts to make them give up their 'watchdog' role.
Speaking at the Scottish Association of Health Councils' annual conference last week, health minister Sam Galbraith said the 'top priority' for health councils lay in 'planning and monitoring the NHS'.
'There is no place in the modern NHS for the old concept of the 'watchdog' where some councils took the easy way out and opposed progress for its own sake or for a good headline in the local newspaper,' he said.
Mr Galbraith acknowledged that councils did not wish to be seen as health board 'lap-dogs', but said their future lay in the co-operative role set out in the Designed to Care white paper.
He reminded them that their recently improved funding status had taken account of this enhanced consultative role.
SAHC director Patricia Dawson said she was 'concerned' by Mr Galbraith's emphasis.
'By and large, health councils are already involved in strategy, and the new structure of trusts in Scotland should make that easier,' she said.
'But to be credible we have to have some evidence to present - and that evidence comes from advocacy services for patients, it comes from patients' complaints and it comes from health councils' members.'
She pointed out that with the advent of the Scottish parliament, health councils would have a political avenue for lobbying.
Fife health council chief officer Christine Johnstone said there was a 'fine line' between working collaboratively with boards and getting too close. 'We have to retain our independence. Our local boards recognise that,' she added.
Moira Bulmer, chief officer of Borders health council, said councils needed to be involved in the 'early stages' of decisions.
'But we should not be seen to be involved in the decision-making process,' she said. 'Our involvement is before and after the decisions are made.'
Mr Galbraith's 'positive noises' about health councils were, however, very welcome, said Ms Bulmer.
Delegates at this year's conference in Erskine, west Scotland, the best attended in years, may have been relieved to hear the minister's comments about their future. There are reports that an early draft of Designed to Care envisaged no role for health councils at all.
As one delegate put it: 'Health councils were to vanish off the face of the earth.'