A bid to allow Liberal Democrats to vote for controversial health reforms to be dropped has failed, the party has confirmed.
Campaigners against the NHS shake-up won enough support to have their "kill the Bill" emergency motion debated tomorrow at the party's spring conference in Gateshead.
But, under the party's alternative vote system, the attempt failed on second preferences.
Instead a rival motion on the Health and Social Care Bill that calls on Lib Dems to support the changes was selected.
That was put forward by Baroness Williams, who initially opposed the proposals.
Responding to the defeat for the grassroots, Labour's health spokesman Andy Burnham said: "This vote is desperately disappointing but the fight against this Bill will go on.
"It is worrying that Nick Clegg appears not to appreciate that the 'Drop the Bill' call is supported by a broad coalition of professionals, patients and people from all political parties. His narrow political appeal to his party will have disappointed NHS staff. It reveals beyond doubt that he is putting party politics before what is best for the NHS."
Benjamin Ramm, editor of The Liberal magazine, said the party could be punished at the ballot box for failing to debate the NHS properly at conference.
“It is ironic that the outcome of this crucial vote was determined by AV – electoral reform being the party’s holy grail," he said. "In supporting this Bill, Lib Dem activists have opted for armageddon: they are the architects of their own undoing.
"This vote, which looks like cowardice – and makes a mockery of Tim Farron’s claim that the Lib Dems are the sole party of conscience – will have serious consequences for activists; if not in the long-term (when the extent of privatisation becomes evident), then in the short term, starting with local elections in May."
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