The vote for David Hinchliffe's new clause is a serious rebuff for the government

Oliver Heald, Conservative health spokesman

The government's proposal has been bitterly opposed by patient watchdog groups, who claim it will rob them of a say in the way their local health services are run.

The proposed new patients' forums are not seen as an adequate replacement by campaigners.

But a compromise proposal by senior Labour MP David Hinchliffe was thrown out by MPs on Tuesday evening.

Widespread opposition

Mr Hinchcliffe's amendment, to create patients' councils to oversee the new forums, was defeated by 296 votes to 222, a government majority of 77.

It is not known how many Labour MPs voted against the government, but the proposals drew fierce criticism from all sides in the house.

Tory health spokesman Oliver Heald said: "The vote for David Hinchliffe's new clause is a serious rebuff for the government and its attempts to stifle the independent community health councils.

"This is one of the lowest majorities for Labour in recent years. It shows the unhappiness of many Labour MPs."

'Muzzling' patients

The government argues its plan of replacing CHCs with patient forums will give the public a stronger voice in NHS decision making.

David Hinchliffe says patients need a voice locally

But opponents say the move is an attempt to "muzzle" the patient watchdog groups.

Mr Hinchliffe said he wanted to ensure "the ability of the patient council members, of the individual forums, to get together and to look across that local health economy in a way that certainly isn't proposed by the bill as it stands."

He praised junior health minister Hazel Blears for her response to his concerns but stood by his amendment.

"We are, I think, inches apart but those inches are extremely important."

'Too vague'

Mr Hinchliffe's compromise solution was backed by the Liberal Democrats, as well as Richard Taylor, the Independent MP elected on a "save Kidderminster Hospital" ticket.

He said the government had never given a proper explanation of why it wanted to abolish CHCs.

He wondered if the reason was that CHCs were a "thorn in its side".

Labour's Patrick Hall said the Government was in danger of being "too vague" about its proposals to replace CHCs.

He praised proposal to create patients councils as "robust and clear" and told Ms Blears she would have to offer a good explanation of government plans to dissuade MPs from voting for Mr Hinchliffe's alternative.

'Disappointed'

Ms Blears said that under the Government's proposals patients would no longer be on the outside of the system.

"Above all the whole of the patient and public involvement system is to be geared around hearing the voices of the people themselves."

She said the plans would give critics what they want and urged them to embrace the new way of working.

Ms Blears said she was a "little disappointed" that Mr Hinchliffe did not seem able to trust the government.

"We are genuinely trying to achieve through this new system, a much more robust, independent and effective system of patient and public involvement," she said.