Scottish people are being asked if they want to spend £5m on introducing direct elections to NHS boards.
The Scottish National Party committed to direct elections to NHS boards in its manifesto. Its consultation on the proposed Local Healthcare Bill is in two parts, the first looking at how existing systems can be improved and the second at direct elections.
The consultation questions whether a move to elections could lead to special interest groups conspiring to get elected then skewing local priorities.
Cabinet secretary for health and well-being Nicola Sturgeon said local people should be at the heart of decision making. "Many people believe that some NHS boards have not taken sufficient account of the views of local people," she said.
But British Medical Association Scotland chairman Peter Terry said elections would not improve engagement and would divert cash away from care. The focus "should be on how boards can improve their own consultation processes", he said.
Since taking power in May 2007, the SNP has reprieved two accident and emergency units and set up scrutiny panels to look at reconfiguration plans.