An NHS constitution would address the 'woefully inadequate' relationship between commissioners and patients, shadow health secretary Andrew Lansley has claimed.

Mr Lansley said it was not always clear to patients where responsibility lay for scandals such as the 2006 Maidstone and Tunbridge Wells trust C difficile outbreak.

Primary care trusts would have more power to intervene on behalf of patients if there were a constitution setting out their powers and accountability, he added.

Speaking at a King's Fund breakfast meeting last week, Mr Lansley said: "West Kent PCT had no idea what was going on at Maidstone and Tunbridge Wells and even if it did, it had no influence.

"The relationship of commissioners to patients is woefully inadequate. If they were accountable to patients that would be a major step forward."

This openness needs to spread across the NHS and Department of Health, he said. In particular, he wanted the NHS management board to make the agendas of any meetings publicly available.

Working alongside an independent board, an NHS constitution would free local trusts from central control and make it clearer what the objectives and resources for the NHS were. He dismissed the idea of legal entitlements, proposed by the Liberal Democrats, as a "legal minefield".

King's Fund deputy policy director Anna Dixon said an NHS constitution will appear in some form as it has been supported by all three political parties. She wants an internal constitution that sets out "who is responsible for what".