Media playback is unsupported on your device Media caption Nick Clegg: "Making GPs more responsible... is not a sort of outrageous idea"

Liberal Democrats have decided against holding a debate calling for changes to the NHS in England to be dropped.

The party voted at its spring conference in Gateshead not to take an emergency motion urging the withdrawal of the Health and Social Care Bill.

Instead it backed Baroness Williams's rival option supporting the changes.

The controversial bill, which aims to give GPs control of much of the NHS budget, has changed "out of all recognition", leader Nick Clegg said.

In a question and answer session, the deputy prime minister said: "I'm determined to make sure the government reaches out to all the family of professions within the NHS, not in a spirit of rancour but in a genuine spirit of co-operation."

And he said of the amended bill: "If I felt it was privatising the NHS or tearing it limb from limb, it would never have seen the light of day."

BBC correspondent Norman Smith, at the conference, said Mr Clegg would be drawing a huge sigh of relief that a vote for the bill to be dropped would not now go ahead.

In the first round of voting, the motion urging the party to drop the bill won 270 votes to 246 for Baroness Williams' motion.

But second preference votes put the "kill the bill" motion on 280, compared with 309 for the motion supporting the reforms.

'Cynical leadership'

Dr Charles West, who proposed the defeated motion, said he was "very disappointed" the party would not get the chance to state its view.

"I think it's astonishing that the leadership has been so cynical as to label it the Shirley Williams motion, she didn't actually write it," he said.

"They've pulled a national treasure out to support them - but in my view the NHS is even more of a national treasure."

We wanted to make sure that the NHS is there so that it's not led by the interests of the private sector Simon Hughes, Liberal Democrat deputy leader

Business secretary Vince Cable told the BBC: "We recognise reform has to happen. There are still a few issues to address, but by and large reforms that the party argued for have now been met."

It was "very difficult" to see why any Lib Dems should now object, he added.

Mr Clegg said earlier on Saturday that he believed members would be "comforted" by the large number of amendments made to the bill since it was originally published.

"I think it's a really good thing that Liberal Democrats worry as much as we do about something as precious as the NHS," he said.

"I think it would be a dereliction of duty if we didn't really really examine hard whether the changes we've introduced in the NHS are the right ones."

The bill aims to give GPs control of much of the NHS budget and would open up the health service to greater competition from the private and voluntary sector.

Some critics argue that the changes will amount to the privatisation of the NHS.

'Big exaggeration'

Last year discontent expressed at the conference about the NHS shake-up was followed by a "pause" on the bill - something Mr Clegg puts down to Lib Dem intervention.

This year's "emergency motion" says the Lib Dems "opposes the further commercialisation of the NHS" by "working together to achieve the defeat of this deeply unpopular bill".

Baroness Williams said: "The facts are the Lib Dems have hugely altered this bill to make a way that makes an acceptable, genuine health service.

"I am sorry about how we got here. But now we're here, we've done huge amounts to reform the bill and make it back to something that supports and doesn't undermine the NHS."

Labour's Andy Burnham had urged Lib Dem activists to help stop the NHS bill, in an open letter on a Lib Dem website.

On Thursday, the government offered a fresh concession to critics who complained that lifting a cap on the number of private patients treated in NHS hospitals would mean work was undertaken at the expense of NHS patients.

Health ministers moved amendments promising "checks and balances".

Unison general secretary Dave Prentis said support for the Lib Dems was now at an "all-time low" and it was "electoral suicide" for the party to support the bill.