NHS Lothian chiefs are fighting plans to elect health boards, saying it would confuse the public and allow pressure groups to take over the running of hospitals.
The Scottish Government wants a proportion of health board members to be directly elected by the public in a bid to make them more accountable and transparent.
But NHS Lothian, which was due to give evidence to MSPs today, wants the plan scrapped.
It will instead put forward alternative plans to increase public involvement in health decisions.
At the moment, health boards are made up of appointed members, council nominees and senior NHS personnel. Under the Government's favoured model, directly-elected members and councillors would form a majority on boards, with NHS executives in the minority. Elections, using the single transferable vote, would be held every four years, with a voting age of 16, and two pilots would start in 2010.
In a written submission to the Scottish Parliament's health committee, NHS Lothian's board argues the existing system was delivering benefits to the people of Lothian and there is no need to change.
It said: "We suspect further wholesale change to the current system has potential to destabilise boards. The fears of elections being overwhelmed by single issue candidates is we believe a real issue.
"A mix of four types of board members – appointed chair, stakeholder appointments (employee director, etc), local authority and directly elected members – could stand to confuse the public and the board itself." The board said it was looking at its own alternative for increasing accountability to local people and "a new type of participation with local communities".
"NHS Lothian is proposing to build on the long history in Scotland of mutual societies and create an NHS Lothian mutual membership forum. This membership will then elect representatives to a new 'Involving People Committee', which would be a formal board committee."
It called for pilots to be set up to assess alternatives to the Scottish Government's proposals.
"We suggest that by only testing direct elections, an opportunity is being missed to achieve the ambition of widening and strengthening the involvement of the public in our NHS. The emphasis on one model could detract from, and focus scarce resources on a single solution, where actually other models could be tested."
Livingston SNP MSP Angela Constance, however, said health boards should stop "squirming, wriggling and manoeuvring" to avoid direct elections.
She said: "The question has to be asked, what are they afraid of?
"Why should they be different from democratically-elected councils which also have to deal with complex issues, large sums of money and make difficult decisions?
"I would call on NHS Lothian to step up to the plate, bite the bullet and put itself forward for a pilot for direct elections."
