If the Liberal Democrats hold the balance of power in a hung parliament, then we now know what their number one health bargaining chip would be.

So how acceptable would locally elected primary care trust boards be to either a Conservative or Labour minority administration? The idea does not appear to sit elegantly alongside the Tories’ desire to empower GPs, although it could fit with David Cameron’s ‘Big Society’. Labour could fold it into plans to increase public involvement, but would find stern resistance from its local government arm.

If the UK had a more health-literate population, elected PCT boards could be a powerful force for reform. But we do not

But is it a good idea? In two words, not now.

The NHS faces an urgent need to reconfigure its services to drive out efficiency savings and prepare it for future demands. The creation of elected boards will slow that process as representatives get up to speed. Where boards have been captured by vested interests it could stop it dead. Meanwhile the financial crisis that is likely to start sweeping over PCTs will bite deeper.

The Liberal Democrats point out that the idea has worked elsewhere, but the demands of the next few years make it inappropriate. If the UK had a more health-literate population, elected PCT boards could be a powerful force for reform. But we do not.

Time and experience will hopefully change that. For now Mr Lamb should find another bargaining chip.

Elected PCT boards - we're not ready