The NHS and the Liberal Democrats may be heading for a "catastrophic train crash" by pressing ahead with the coalition Government's controversial health reforms, an MP has warned.
Lib Dem MP Andrew George, a vocal opponent of the Health and Social Care Bill, told members at the party's autumn conference in Birmingham that the plans represented the "biggest upheaval" in the NHS's history at precisely the time when it needed stability and certainty.
The St Ives MP said: "I want to do my best to save the NHS from what I believe may be a catastrophic train crash, which I fear may take the party with it."
Mr George, who is a member of the Commons Health Select Committee, said the proposals raised the "very real risk" of producing an NHS driven more by private profit than concern with patient care.
He claimed the reforms represented "a major missed opportunity" to produce a service which was more accountable to communities and patients.
He said the amendments secured through the pause in the Bill's passage only took the party to the "foothills" of the mountain.
Mr George claimed the reforms were "primarily a Tory plan, with our grudging support or possibly acquiescence".
He said: "I think the future fate of both this party and this coalition Government needs to take heed of the concept that, actually,'it's the NHS, stupid'."
Liberal Democrat activists used the debate to vent their anger at the proposals.
Many at the party's conference are frustrated that they have not been given a fresh vote on the Lib Dem attitude to the Bill.
Lib Dem MP John Pugh said the reforms took the Blairite model of the NHS to its logical, ultimate and slightly disturbing conclusion.
Mr Pugh, co-chairman of the Lib Dems' backbench health committee, added it was "absurd and unhelpful" to have the NHS and private providers at loggerheads by making the private sector no longer a helpful partner but a rival
Activist Linda Jack, from Luton, said the Bill went far beyond the compromise contained in the coalition agreement and "we should never have got into this mess".
She added: "Nick (Clegg) should never have put his name to it, because it wasn't what we agreed."
There were cries of "shame" from the floor when she reminded party members that they had not been able to vote on a health motion at this conference.
Charles West, from Shrewsbury and Atcham, who has been a prominent figure in the Lib Dem grassroots opposition to the reforms, compared the Bill to a "leaky ship".
"If it sails at all it will go in the wrong direction," he said. "I'm more worried that the ship will sink and that the NHS will sink with it, and if our name is on that ship we will go down as well.
"And, friends, we deserve to."
He added: "They say they are not privatising the NHS because it will still be free at that point of use. What's that got to do with it? Private prisons are still private but the prisoners don't pay to go there."
Former MP and doctor Evan Harris, said the Bill "currently goes well beyond the coalition agreement in implementing Tory policy and falls well short of the coalition agreement in delivering Liberal Democrat policy".
Lib Dem grandee Baroness Williams is set to be a key figure in the Bill's battle to get through the Lords and Dr Harris called on the party's peers and MPs to support her changes to the legislation.
Lord Marks said he would work to remove the Health Secretary's duty to promote autonomy for health bodies from the Bill in case it provided a legal justification for failing to intervene in the provision of care.
"In my view the Bill would not be materially weakened as a matter of law just by deleting the two duties to promote autonomy, because the structure itself builds in decentralisation and autonomy," he said.
"The central point is that, for the Secretary of State, the buck must stop with him. Amendment in the Lords ... could, in my view, achieve that."
Norman Lamb, a parliamentary aide to Mr Clegg and a former Lib Dem health spokesman, insisted the Government remained open to further changes in the Lords.
He said: "If the Bill can be improved then that can happen in the House of Lords. And remember, what Bill goes through the House of Lords these days without getting significantly changed?"
He added that the Secretary of State's responsibility to provide a comprehensive health service, a major concern for Lib Dems, would be "put beyond doubt".
The Bill removes the cap on the amount of private income foundation hospitals can earn, but Mr Lamb insisted that would benefit patients.
He said: "We should require foundation trusts to demonstrate how non-NHS income is benefiting NHS patients. I know views vary on this issue, but the debate must be had in the House of Lords so that we get it right so that any private work is done for the benefit of NHS patients."
Activist Prateek Buch, from Chingford, criticised the "rather tame format" of the conference debate which meant members could not have a vote on the situation.
"We may well have preserved party unity, we may well have prevented what many saw as a threat to coalition stability ... but what neither you nor I want is for Liberal Democrats to be a stable, united partner in a Government that backs the wrong policy, that goes beyond the coalition agreement."
He added: "We must never allow the democratic soul of this party to be sacrificed for the sake of perceived party interest when it is not in our party's interest, nor that of the country, to back a bad Bill."