'Lib Dem MP Norman Lamb found himself uncomfortable with the party's hostility to NHS choice'

At 10am this Friday morning North Norfolk Lib Dem MP Norman Lamb is at Hindolveston, by the war memorial at the junction with Melton Road, if any constituents want to catch up with him.

At 1.45pm he is outside Edgefield village hall, and by 4pm at the lay-by on the main road at High Kelling. It is all part of his annual 'village surgery' tour, a week spent visiting outlying settlements in his outlying constituency, where larger towns like Cromer, Sheringham and Wells are not large at all.

But Norman Lamb has other things on his mind. Since being appointed the party's health spokesman by Sir Ming Campbell last December he has been immersed in what is for him a relatively new subject, though his mum was a nurse and health was a dominant issue when he served on Norwich council.

Next week he is to put his own stamp on Lib Dem health policy ahead of the Brighton conference. Not much he can reveal at this stage, but he offers HSJ a series of broad principles which now guide him.

Mr Lamb is only a Norfolk boy by adoption. When he was 14 the family upped sticks because his father, Professor Hubert Lamb, was setting up what became the pioneering climatic research unit at the new University of East Anglia.

A natural middle-of-the-roader, young Norman was Labourish, but fell under the spell of the breakaway Social Democratic Party founder member Shirley Williams.

As a solicitor specialising in employment law he entered local politics and won North Norfolk from the Tories in 2001.

By 2005 he had almost doubled his 1992 share of the vote to a huge 53.5 per cent - a familiar Lib Dem story of digging-in. His website shows hyperactivity, a quote for everything and, if your chip shop wins an award, Norman will be there for the photo.

Little wonder Sir Ming appointed his mate chief of staff, a job he liked. But when Northavon Lib Dem MP Steve Webb, policy wonk of wonks, decided to concentrate on the next manifesto, the health job fell vacant and Lamb was persuaded to take it.

He found himself uncomfortable with the party's hostility to NHS choice when it favours empowerment of individuals. He praises the government's extra funding, but believes much of it has been wasted by excess centralisation.

'The NHS is hopelessly over-centralised. The government confused command and control from the centre with the drive towards marketisation, each pushing in different directions,' he complains.

So, those basic principles include decentralisation and empowerment. As the Wanless report points out, better self-care leads to better outcomes. Is there scope for extending direct payments from social care to chronic care, he asks.

Patricia Hewitt used her final speech as health secretary to point the way to local accountability, he notes. Mr Lamb's experience as a Norwich councillor points that way too.

If you accept the commissioner/provider split and see how it works in Sweden or Denmark - not far from Cromer really - you see how Norfolk's recently merged primary care trust could become a directly elected board. Elected local councils never get into debt as Norfolk's PCTs did, Mr Lamb says.

And why not make it an integrated health and social care board, as in Northern Ireland? There might even be scope for health income from local income tax.

But steady there. Those Lamb principles also include equity and fairness. Not much point offering old or poor rural voters choice if there is no public transport on which to exercise it. So central government remains present to redistribute resources and keep people up to the mark.

Lamb knows efficient use of the cash is an important principle too. NHS managers don't want endless reorganisations.

He is impressed by local empowerment policies promoted by forces as different as Nick Bosanquet, director of the pro-market think tank Reform and the left-leaning Institute for Public Policy Research. As for that lovely over-priced Norfolk and Norwich University hospital, built under the private finance initiative, don't get him started.