Patients' watchdogs have called for a 'complete, radical reform' of the health service to make it more accountable to the public.

The NHS is 'the least accountable of Britain's major public institutions', according to a report launched at the Association of Community Health Councils for England and Wales' annual conference this week.

Will Hutton, chair of the commission on representing the public interest in the health service, which was set up by ACHCEW, said the NHS was 'run as a top-down, central bureaucracy'.

A more accountable NHS would bridge the gap between government and citizens over health care, with patients increasingly turning to the courts for redress.

The commission will lead a consultation on options for change. Its report says these could include handing over the health service to local authorities or removing the NHS Executive from the Department of Health.

Interim report of the commission on representing the public interest in the health service. www.achcew.org.uk