TORONTO - The fate of regional agencies charged with making local health care decisions will be hanging in the balance this fall when Ontario voters head to the polls.

The governing Liberals want to keep the 14 agencies they created to streamline health services, while the Conservatives and NDP are promising to wipe them out.

The government says the Local Health Integration Networks are needed to make local decisions.

But critics say it's just another layer of bureaucracy that's ignoring the needs of many communities.

Natalie Mehra of the Ontario Health Coalition says the agencies must be scrapped and replaced with smaller, more democratic groups.

She says the agencies essentially take the heat off the government for its health-care decisions by acting as a buffer between the province and local residents.

Hospital unions are warning that scrapping the LHINs could lead to another round of health service restructuring and years of turmoil.