Norman Lamb denied last night that he is threatening to quit the government, but warned that its controversial NHS reforms must be slowed down and changed.

Norman Lamb denied last night that he was threatening to quit the government, but warned that controversial NHS reforms must be slowed down and changed.

The North Norfolk Liberal Democrat MP told the EDP that NHS reform was essential, but that it should be “evolution, not revolution”. Instead of “a big bang”, he said, the government should “slow it down, allow evidence to gather and see how it works”. Otherwise, there would be a major financial risk to the NHS, and patient care could suffer.

Earlier in the day he told the BBC’s Politics Show that the government was “on the hook” over health secretary Andrew Lansley’s plans, which could cause financial risk and harm to the care of patients.

If they were not modified, he would find it “impossible” to continue as the chief parliamentary adviser to deputy prime minister Nick Clegg, he warned.

But he had alerted his party leadership to what he intended to say in the interview, and was not told to hold back. The implication was that his message had been approved by Mr Clegg. And with Lib Dem cabinet minister Danny Alexander also speaking on TV of the need to alter the NHS plans, it looked as if the party leadership had decided publicly to warn the prime minister that the coalition could be at risk if Mr Lansley were not reined in.

Unless changes to the NHS reform legislation were made on the lines he was suggesting, Mr Lamb told the EDP, it would not become law because it would not get through the House of Lords. And he emphasised: “I am not threatening to quit at all. I want to help the government get to a position in which the bill can proceed.”

At the heart of the reform plan is a proposal to scrap primary care trusts and shift responsibility for the commissioning of as much as 80pc of patient treatment and its funding to groups of GPs.

The scheme has run into intensified opposition from medical professionals, including the British Medical Association and the Royal College of Nursing, as well as the Labour Party which is claiming that is a front for increased privatisation of the NHS.

It was also rejected recently at a Lib Dem conference, and Mr Lamb’s words could cause further friction between the two governing parties. But the Norfolk MP stressed that he knows for a fact that some of his misgivings are shared by Conservative MPs.

Growing concern on the Tory benches in the Commons that Mr Lansley was marching the government into a damaging political storm has been noted in 10 Downing Street. It was reflected in the prime minister’s announcement last week that the plan had been put on pause and that the government would ‘listen and engage’ for two months. But some opponents of the proposals fear only minor or cosmetic changes will follow.

Mr Lamb called for the health reforms to mirror those in education, where schools have the opportunity to opt into academy status rather than being forced into it.

“The principle at the core of this - of giving GPs more power and responsibility - is absolutely right. But whenever you introduce new structures, of course there is no evidence, so the sensible thing to do after this period of reflection is test it, see if it works, and it would gather a momentum of its own”, he said.

He was his party’s shadow health secretary before the general election, and eyebrows were raised by his exclusion from Mr Lansley’s ministerial team when the coalition was formed. Some commentators have speculated that the health secretary exercised a veto because he had been offended by some of the Norfolk MPs’ previous criticisms of his policies.

Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), agreed the reforms were being brought in too fast.

He said: “We have never seen any as big as these (reforms) or as fast as these. It’s worrying when so many MPs are saying to us they don’t understand what they are looking at.”

And he added that Mr Lamb is “a man who knows his way around the health service” and that he has “an enormous amount of credibility”.

Treasury chief secretary Danny Alexander - also a Lib Dem - suggested yesterday that “substantive” changes to the NHS proposals could be made, particularly with regard to the proposed GP-led commissioning.

“This listening exercise is a real opportunity for the government to hear all those concerns,” he said on the Andrew Marr show. “We intend to come back with serious, substantive changes to this Bill as a consequence of this process.”

• EDP Opinion: page 16.