Government proposals to make the NHS more accountable to patients will actually exclude the public from long-term decisions worth billions, MPs heard last week.

Giving evidence to the Commons health select committee, Sharon Grant, chair of the Commission for Patient and Public Involvement in Health, said that by the time new organisations were set up to replace patient forums, primary care trusts would already have made crucial long-term decisions on commissioning.

She said Department of Health proposals to scrap her organisation and the 570-plus patient and public involvement forums in England would result in less accountability.

The Local Government and Public Involvement in Health Bill, which was laid before Parliament in December, sets out plans for local involvement networks (LINks), which would be local authority-based and roughly match the boundaries of the 152 primary care trusts in England.

But Ms Grant said PCTs would take spending decisions before LINks had had time to mature into effective scrutiny and involvement organisations. 'Commissioning contracts would have been made lasting for five years or more from which the public would have been largely excluded.

'I have serious concerns about what these proposals will actually do for the public involvement agenda.'

And she added: '[Ministers] really need to think about the message all this chopping and changing means for genuine local involvement.'

Ms Grant and fellow witnesses Elizabeth Manero, the chief executive of patient involvement charity Health Link, and Barrie Taylor, the chair of Westminster Council's health oversight and scrutiny committee, said that rather than starting afresh, patients forums should be allowed to evolve and involve many other interest groups. They pointed out that many were already doing this.

Independent MP for Wyre Forest Dr Richard Taylor, who came to office on a wave of patient anger at plans to downgrade Kidderminster Hospital, suggested to Elizabeth Manero that the bill was 'rather vague' and that LINks needed a 'central group', which could feed information to others.

Ms Manero described the proposal for LINks as 'an amorphous, fluctuating group of people with no leadership and little accountability'.

Dr Taylor summed up the view of the committee: 'We all feel that the existing system could be refined and built up and needs a further two years gestation to help it grow its capacity'.