Local campaign groups have claimed that the failure of two major hospital projects to win private finance initiative approval as a victory for 'people power'.
Three out of nine projects put forward for 'third-wave' approval were rejected on the advice of the NHS capital prioritisation group, it was announced last week.
Two - in Wakefield and West Hertfordshire - were marked by high-profile public campaigns against the schemes. But managers insist they could still proceed in later waves of PFI approvals.
Controversy surrounding Pinderfields and Pontefract hospitals trust plans to relocate acute services from two hospitals to an 'acute specialist centre' became the subject of a Channel 4 television programme.
Unison members and local activists set up North Yorkshire Parish Community Group, whose demands for a referendum on PFI were screened on the Mark Thomas Comedy Product .
Mick Griffiths, Unison joint secretary at the trust, said he was 'absolutely certain' the high-profile campaign - backed by a 15,000 strong petition - was central to the bid's rejection this year.
In a letter to the HA, health minister John Denham acknowledged the need to redevelop 'sites with poor-quality capital stock' and 'unsatisfactory clinical integration'.
He said he saw 'no reason' why the scheme should not succeed in the future, but questioned whether the options under consideration were 'sufficiently innovative.'
The HA said it remained 'optimistic' that the plans would be approved in the future.
In West Hertfordshire, three local campaign groups were backed by an alliance of five district councils in a threat to take West Hertfordshire HA to judicial review if proposals to downgrade hospitals and create an acute site proceeded.
South West Herts community health council referred the plans to Mr Denham - who has yet to announce his decision.
In a letter to local MPs explaining the failure of the bid, Mr Denham stressed: 'It is not clear what degree of local support there is for a scheme that would involve closing at least one and probably two district general hospitals.'
Action groups in West Hertfordshire said the decision 'reflected a great deal of hard work from local people' which had 'brought the schemes into the political spotlight.'
Lorna Halsey, Unison staff-side chair at Mount Vernon and Watford Hospitals trust - one of three within West Hertfordshire - compared the HA's attitude to 'a broken record' .
The HA insisted that the failure of its PFI bid was entirely separate from the 'far more critical' ministerial decision still awaited.
Kent and Sussex trust's PFI bid was also rejected for the third wave.
Chair Mary Symes described the news as 'extremely disappointing - a view shared by Tunbridge Wells CHC, which had given 'its full support' to the trust's third attempt to succeed in winning priority for PFI.
Six schemes given green light Prime minister Tony Blair announced last week that six hospital developments worth a total of£648m would proceed in the third wave of PFI approvals.
The new developments, which all involve acute service rationalisation, are:
The number of new hospitals given the go-ahead since the government came to power is 37. The number of hospitals under construction is 17, of which 13 are funded through PFI.