Health vote is branded `mad' by MP

The party conference plunged itself into new controversy yesterday by voting for local authorities to commission National Health Service care as part of a new policy which otherwise leaves the Liberal Democrats accepting significant parts of the Government's health reforms.

The decision was privately described as "mad" by a senior Liberal Democrat MP, and was the subject of marked controversy at a fringe meeting held by the Royal College of Nursing immediately after the debate. Local government control of health would also be fiercely resisted by the British Medical Association.

Liz Winder, the RCN's director of policy, warned it could lead to wide variations in standards of care, more means testing of patients and a loss of expertise in the commissioning of care. The college, she said, had "grave concerns" over the decision.

The conference voted firmly for the move which restates existing policy. Alex Carlile, the party's health spokesman, had hoped to put off the eventual merger of health and local authorities, making it subject to a review of the structure and functions of local government and the development of regional assemblies.

Party members voted for the move by a substantial margin despite a warning from Simon Hughes, the MP for Bermondsey, that councils were not in a position to take on the extra workload at a time when regional assemblies did not exist and many councils were being broken down into smaller unitary authorities.

Jonathan Oates, a councillor in Kingston which has put in a bid to the Department of Health to pilot local authority purchasing of NHS care, told the conference that the move was needed to provide "seamless care" between health and social services and to make health care decisions accountable.

Proposing the successful amendment, he said: "We stand full square against the unelected state and we demand democracy and accountability of all who exercise power over our lives." The party should stand by its existing policy, he added.