Members of the public will be directly elected to the boards of NHS Fife and NHS Dumfries and Galloway from next year, Scottish health secretary Nicola Sturgeon has announced.
Elections will be held for the first time in the spring. The system, using postal ballots, will run for at least two years before an evaluation.
Ms Sturgeon said: “This is designed to ensure that the views of local people about the NHS services they pay for can no longer be ignored.
“This approach reflects the ideals laid out in the publication ‘Better Health, Better Care’ for a mutual NHS.
“I am confident the people of Fife and Dumfries and Galloway will welcome this chance to be at the heart of healthcare decisions and their examples could set the pattern for the whole of Scotland.”
As well as the election pilots, NHS Lothian and NHS Grampian are to trial other improvements to boards’ existing engagement and involvement systems.
The Scottish government will meet the cost of the elections - estimated to be just under £3m.
Unions have said the elections will bring about a necessary change of culture on health boards, but doctors’ groups have criticised the extra cost.
Ms Sturgeon said: “Elections to health boards are a crucial step in improving public confidence in the decisions made by boards, which spend billions of pounds of taxpayers’ money.
“When vital services are at stake, it’s absolutely essential that the voices of local people are listened to and the best way of achieving this is by actively involving them at the ballot box and in the boardroom.”