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MP Norman Lamb says he agrees with giving GPs more power, but attacks ‘risky and destabilising’ speed of legislation One of Nick Clegg’s closest allies today expressed “very real concerns” about the coalition government’s NHS reforms and threatened to resign if the pace of change was not checked. Norman Lamb, chief political adviser and Commons aide to the deputy prime minister, said he agreed with the principle of giving GPs more power and responsibility, but insisted the shift needed to be “more evolutionary”, claiming there was “no evidence” about how the proposed GP-led commissioning bodies would work, even though they are supposed to be up and running by 2013. Appearing on BBC1′s The Politics Show, Lamb said he had spoken to Clegg about his intention to appear on the programme, but insisted that he was speaking for himself. “As things stand I have very real concerns and I think it’s right for me to express those,” he said. “My real concern is the financial risk of doing it too quickly because then services and patient care suffers and the political risk is enormous, and most of all, for everyone who cares about the NHS and I think the Government does, we’ve got to get this right.” “Surely we should be doing an evolutionary approach in health as we are doing in schools … That way I think the government can get itself off the hook that it is on at the moment, it can get a lot of professionals back on board, and most of all it can reduce the financial risk.” Asked whether it could be a resignation issue, he said: “I’ve said if it’s impossible for me to carry on in my position I will step down, I don’t want to cause embarrassment, but I feel very strongly about this issue. “And I think it’s in the government’s interest to get it right in the way that I suggest.” Challenged that it would be destabilising to the government if he walked out, he added: “It would be incredibly destabilising politically if we get this reform wrong.” Lamb insisted change in the NHS was necessary because of rising health costs and that GPs should be given a bigger role: “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. “It would be a crying shame if that really important principle was lost because we rushed the reform process and get it wrong. The intervention by an MP so close to Clegg is a sign of the scale of the challenge the coalition government faces in winning over the Liberal Democrats. Ministers announced last week they were going to “pause” the health reforms amid widespread opposition among NHS professionals, patients groups and rank-and-file Lib Dems. The shadow chancellor, Ed Balls, said Lamb’s comments were “very significant indeed”: “Clearly Norman is very close to Nick Clegg, he’s his closest political and parliamentary adviser,” he told the BBC. “He made a very important point, which is that we shouldn’t see reform as always good. There are good reforms and there are bad reforms. “These are bad reforms, they are not popular, they won’t work, they will be destabilising financially and also in terms of treatment. What we don’t want is a pause or a PR initiative. What we want is the government to say ‘we got this wrong’.” David Cameron and the health secretary, Andrew Lansley, will hold a round-table meeting with representatives of the voluntary sector on Wednesday morning. Lansley will then attend the Royal College of Nursing congress in the afternoon. More public engagement events will follow over the coming weeks, supported by the new NHS Future Forum made up of patient representatives and healthcare professionals. Danny Alexander, the Lib Dem chief secretary to the treasury, said the government would come back with “substantive” changes to the Health and Social Care Bill. “We have to go forward with reform which is about empowering people within the NHS to take more responsibility for themselves,” he said. “It’s something where, of course there have been concerns raised by Liberal Democrats and elsewhere, and this listening exercise is a real opportunity for the government to hear all those concerns.” Health policy NHS Health Nick Clegg Liberal Democrats Liberal-Conservative coalition Andrew Lansley guardian.co.uk