The government moved to position itself firmly on the side of patients this week, as a series of initiatives and ministerial speeches surrounded publication of the Alder Hey report.

But simultaneously patients' groups criticised removal of former Patient's Charter rights in a revised document, Your Guide To The NHS.

In a speech to patients' organisations at the King's Fund, health secretary Alan Milburn declared that legislative changes were needed to put the doctor-patient relationship on a more modern footing.

'I want the balance of power in the NHS to shift decisively in favour of the patient, ' he said, adding: 'I believe it is so fundamental it will also require changes to the law.

'Above all else, for trust to thrive, there has to be informed consent.

Not a tick-in-the-box consent regime, but consent that is based on discussion and dialogue.

Where consent is actively sought and positively given. '

He insisted that patients should have options for treatments fully explained and that the 'traditional paternalistic' attitude of the NHS was no longer acceptable.

'There is a simple principle at stake here. The health of the patient belongs to the patient. '

The speech followed the launch of Your Guide To The NHS - a replacement for the old-style Patient's Charter which has drawn criticism from health organisations because of the lack of patient input and its focus on patient responsibilities rather than rights.

Patient Concern director Roger Goss said: 'Unfortunately, there is a big contrast between the sentiments expressed in the speech - which we broadly agree with - and the actual tenor and content ofYour Guide To The NHS, which far from substantiating patients' rights actually gets rid of them, replacing them with expectations. '

Mr Goss said there was 'little new and nothing impressive about the expectations outlined' in the guide, which was 'heavy on patronising advice' and 'the obligations of patients'.

Concerns about the new guide have also been raised by the Association of Community Health Councils for England and Wales and the King's Fund.

Mr Milburn signalled that he would consider a feasibillity study into an independent national patients' organisation, but Donna Covey, director of ACHCEW, said:

'Perhaps it might have been sensible to consider the need for a national body and independent advocacy before forcing the abolition of CHCs and their national body through Parliament. '