Fears that direct elections to health boards would suffer from low turnout and a lack of candidates were voiced to MSPs yesterday.

Fears that direct elections to health boards would suffer from low turnout and a lack of candidates were voiced to MSPs yesterday.

Medical and nursing representatives said plans to hold elections for the public to serve on boards would not improve accountability or increase participation.

The British Medical Association said there was no evidence that elections would change how boards work and the Royal College of Nursing (RCN) is concerned that the candidates would continue to come from a small group of people.

The groups were giving evidence to the Scottish Parliament Health and Sport Committee on the Health Boards (Membership and Elections) Bill.

Public sector union Unison also put forward its case in favour of the plans, stating democracy should be extended to the NHS.

Rachel Cackett, RCN policy adviser, cited New Zealand as an example of public apathy towards health board elections.

She said: "The numbers for New Zealand are only half of that in a general election, which has around 80% turnout. If that was the same here it would be very low."

Dr Dean Marshall, chairman of the BMA Scottish GP Committee, said: " There is a big issue about who gets to be on the boards. If you look again at New Zealand, 34% have professional experience of health, another 30% are in business or law and 11% are employed in the health service. It is the same type of people you are seeing. The New Zealand experience doesn't support the view that those who are not currently involved get involved."

However, Unison said that public interest in health issues was great enough to ensure increased participation.

Dave Watson, Unison Scottish organiser, said: "We don't believe direct elections to be a panacea for public engagement with the NHS. A problem has been the NHS hasn't had direct engagement with the public.

"The difference between publicly provided services and private sector services is democracy. We have a large number of quangos. Health boards are the largest quangos in Scotland and they should be democratised."