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25 October 2011 Last updated at 18:47 GMT 
Baroness Williams wants greater clarity as to the health secretary's role under the NHS reforms Peers debating the controversial health bill have raised concerns about the ambiguity of the role of the health secretary under the NHS reforms.
Lib Dem peer Baroness Shirley Williams said a major health emergency in the country was an example of when the secretary of state's role was unclear.
A Conservative peer is tabling an amendment which would explicitly state the role's responsibilities.
A government source said whips would "look favourably" on the amendment.
Lord Mackay's amendment states the health secretary retains ultimate responsibility to parliament for the provision of the health service in England.
The debate was adjourned before a vote on the amendment could take place, but will resume next week.
The Health and Social Care Bill - currently at committee stage in the House of Lords - would increase competition and put GP-led groups in control of buying care in their areas.
Ministers say the changes are vital to help the NHS in England cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.
They say the bill, which has already been substantially altered following criticism from NHS staff, opposition and some Liberal Democrat MPs, now has wide support. But leading medical professionals have warned that the proposals are still unpopular.
Speaking in the House of Lords, shadow health minister Baroness Thornton said the bill still failed to reassure people and NHS staff, and a defining set of principles was required.
Continue reading the main story Jan 2011: Commons First and Second readings. Approved with no rebellionsFeb - Mar: Commons committee stage, various amendments accepted on competition4 April: Bill "paused" following widespread criticismApril - June: "Listening exercise" conducted by NHS Future ForumJune - July: Bill sent back to Commons committee stage. MPs approve further amendments prompted by listening exercise 6 - 7 Sep: Commons report stage and Third Reading - approved with four Lib Dem rebelsSep: Bill arrives in the LordsOct 12: Lords reject bids to block the bill altogether and to send parts of it to a special select committee Christmas? Ministers would like the bill to get royal assent by then but even without further delays, there are still several stages to go throughApril 2013? Further delays notwithstanding, NHS commissioning groups due to take charge of budgets then"Only clarity around the principles will get them to take NHS staff with them," she added.Baroness Williams said it was crucial that accountability for £120bn of taxpayers' money spent on the NHS and other health services was retained directly through Parliament.
"That means that we have to make it clear that the channel passes through the secretary of state," she said.
Former SDP leader Lord Owen called it a "disastrous" bill, which would "unutterably change the principles of of the NHS".
"I have lost any hope of convincing the government or the Liberal Democrat benches about the substance of the bill. This is going to go through - it's unfortunate but that's the reality," he added.
"People do forget the market value of having a very substantial national health service. I think this has been fragmented with wilful disregard.
"I cannot understand how the Treasury has accepted the disbandment of the procurement policies of the NHS which have ensured far more value for money than in any other health service around the world."
Later, crossbench peer Lord Walton of Detchant, a former president of the British Medical Association, said the bill should make clear that the NHS should "provide education and training for its workers".
Several peers, including the health minister Lord Howe, have put down amendments on the issue.
Lord Howe's amendment, which is expected to be accepted, specifies that the health secretary should ensure there is an "effective system for the planning and delivery of education and training".
Earlier this month, the House of Lords rejected a proposed amendment that would have referred parts of the bill to a special select committee.
The reforms have been one of the most controversial areas of government policy over the past year and had to be put on hold in the spring amid mounting criticisms from the medical profession, academics and MPs.
It led to ministers making a number of concessions, including giving health professionals other than GPs more power over how NHS funds are spent as well as watering down the role of competition.
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