Plans to contract foreign firms to cut NHS waiting lists have been shaken by the decision of one local group to boycott an eye surgery scheme.
Some of the centres will focus on cataract surgery
The primary care trust covering south west Oxfordshire, which represents thousands of patients, voted not to take part in a mobile clinic scheme.
Hospital consultants had feared that the private plans would wreck services at the local eye hospital.
The health authority, which supports the scheme, said it was "disappointed".
Ministers have guaranteed that the company's surgeons will be sent a minimum number of cases - and the loss of south west Oxfordshire involves 1,800 fewer patients at a stroke.
However, the Department of Health said that the withdrawal should not affect the viability of the contract, as it catered for more than a dozen primary care trusts in all.
The government is relying on this contract, and dozens like it, to reduce waits for some of the most common conditions such as cataracts.
In all, Health Secretary John Reid intends to spend in the region of £2 billion on private contracts. However, he is committed to increasing autonomy at grass-roots level in the NHS, and local health organisations still have the choice on where to send their patients.
The scheme was voted down at a trust meeting on Thursday.
Although executive board members were in support, non-executive members voted against.
'No real benefits'
Liberal Democrat MP, and former health spokesman, Dr Evan Harris, attended the meeting.
He told BBC News Online: "The people who objected to the scheme didn't think it would offer any real benefits to patients.
"There was also a massive potential financial risk to the primary care trust.
"The trust's figures suggested, that by 2005, when the contract was due to begin, there will be no long waits for eye surgery at the John Radcliffe Hospital in Oxford.
"Essentially, you'd just be transferring activity from one provider to another - and destabilising the John Radcliffe."
He said that the same circumstances could well apply to diagnostic and treatment centre contracts in other parts of the country.
A spokesman for the Thames Valley Health Authority said: "We know treatment centres are very beneficial for patients so we are surprised and disappointed by the decision."
Similar board meetings for other primary care trusts in Oxfordshire are scheduled for next week.
A spokesman for the Department of Health defended the centres, saying: "The Independent Sector Treatment Centre scheme, using a series of 'state of the art' mobile units, will visit areas across England with a team of specialist ophthalmic surgeons performing much needed cataract removals on NHS patients.
"At least fifteen PCTs have already signed up to the programme, which will cut waiting times and introduce choice for NHS patients.
"The scheme is part of the Government's plan to introduce extra capacity into the NHS and bring down waiting times, particularly for cataract removal, where an operation can bring an immediate and major improvement in the quality of life for people suffering from the condition.
"The mobile units will be able to visit those places where NHS patients need this operation most."