Clinical commissioning groups should be required to have a nurse and doctor with secondary care experience involved in executive decision making roles rather than on a governing board, Baroness Shirley Williams has said.

Baroness Williams – a leading Liberal Democrat who has campaigned for changes to the government’s NHS reforms – was speaking at a fringe event hosted by the Smith Institute and Asthma UK, at the party’s conference yesterday.

She said she was pleased with the changes made to the government’s plans during the summer and suggested the reforms may now contribute to improving services. Lady Williams said they “may be in the end beneficial to everybody associated with the NHS”.

However, she said she still had concerns and would call for further changes when the Health Bill was debated in the Lords next month.

Speaking about the change in plans to require CCGs to have a nurse and doctor with secondary care experience on their board, Baroness Williams said: “There is some discussion in the Department of Health at the current time… that these other representatives should [sit on] corporate governance boards as distinct from [being] decision makers.”

She said this was wrong and they should not be “whizzed off to some corporate board which meets four times a year”.

Baroness Williams also called for further changes to the bill to ensure the health secretary retained responsibility for securing provision of services. She also said government regulations which will follow the bill – for example to set out governance rules for CCGs – should have to be reviewed by the Commons health committee rather than only being “rubber stamped” under the normal parliamentary process for regulations.

She said: “If we don’t do that the regulations might undermine everything we have done [in amending the bill/reforms].”

Baroness Williams is also calling for plans to scrap foundation trusts’ private patient income cap to be dropped. Instead, she told HSJ, she will propose a system where at least a majority of FTs’ income should be from NHS patients; and each FT should agree a cap with the regulator Monitor. Currently each FT’s cap is set at a historic level.

Last week health minister Earl Howe indicated the government would amend the bill to require FTs to explain how their private income is benefiting NHS patients.

Earl Howe said in a Lords debate: “We are confident that, as and when the cap is lifted, private income will benefit NHS patients. We are determined that that should be seen to happen.

“However, we will explore whether and how to amend the bill to ensure that foundation trusts explain how their non-NHS income is benefiting NHS patients.”