NHS bosses in England and Wales are being encouraged to hold some meetings outside normal office hours, vary the venues and invite local interest groups to give presentations or take part in discussions on set topics.

Health authority and health trust meetings have not been held behind closed doors since Feburary.

The government says primary care groups, which will begin functioning next April, will also have to open their board meetings to the public.

Community spirit

Health Secretary Frank Dobson said: "This government wants to see greater openness and community spirit throughout the NHS.

Frank Dobson: the government wants the NHS to be more open

"The public has a right to see how the decisions are reached on their local health services."

He said this was not a cosmetic exercise: the public needed to understand how health organisations worked and what went into the decision-making process.

"Only in this way will we widen public participation in the running of the NHS," he said.

Practise what you preach

However, NHS managers say it is all very well for them to be open, but they want the government to practise what it preaches.

Karen Caines, director of the Institute of Health Services Management, said: "This is a government that came into office preaching the gospel of openness.

"As health professionals are increasingly held to account, it is something that the government must equally bear in mind.

"When can we expect to see the Department of Health and the NHS Executive conducting their affairs in public?"

Ms Caines added that NHS managers accepted the need for accountability and public scrutiny, but she said this needed to be balanced against possible distortion.

"Half-baked reporting by the press can have a devastating effort on a dedicated band of senior healthcare professionals," she stated.

However, she welcomed the fact that pre-board meeting press briefings were proposed in the guidelines, saying this could reduce distortion.

The NHS Confederation, which represents NHS managers, welcomed the guidelines, particularly for primary care groups.