Clegg aide threatens to quit over reforms

Norman Lamb, chief political adviser and Commons aide to the deputy prime minister, warned he had “very real concerns” about the “very risky” proposals in the Health and Social Care Bill.

The Liberal Democrat MP said he agreed with the principle of giving GPs more power and responsibility, but insisted the shift needed to be more “evolutionary” than planned.

The intervention by an MP so close to Mr Clegg is a sign of the scale of the challenge the coalition government faces in winning over the Liberal Democrats.

Appearing on BBC1’s The Politics Show, Mr Lamb said he had spoken to Mr Clegg about his intention to appear on the programme, but insisted that he was speaking for himself.

“As things stand I have very real concerns and I think it’s right for me to express those,” he said.

Mr Lamb insisted change in the NHS was necessary because of rising health costs and that GPs should be given a bigger role.

But he cautioned that there was “no evidence” yet about how the proposed GP-led commissioning bodies would work even though they were supposed to be up and running by 2013.

He called for the health reforms to mirror those in education, where schools have the opportunity to opt into academy status rather than being forced into it.

“Surely we should be doing an evolutionary approach in health as we are doing in schools,” he said.

“The principle at the core of this - of giving GPs more power and responsibility - is absolutely right.

“But whenever you introduce new structures, of course there is no evidence, so the sensible thing to do after this period of reflection is test it, see if it works, and it would gather a momentum of its own.

“If it works as we hope it would, then others would follow suit, but to do it in one fell swoop would be very risky.”