The paper, published last week, ahead of the party's conference, is Mr Lamb's contribution to its health policy working group, set to report fully in 2008.

His proposals include elected local health boards to put patients in charge of decisions about their local health services, local health taxes and patient advisers in GP surgeries.

A local health 'contribution' - or tax - would allow communities to raise extra money for health services offset by cuts in national income tax.

Patient advisers would provide universal NHS information services via the GP surgery.

The document also outlines a 'patient's contract', declaring the entitlements that all citizens should have.

The Liberal Democrats are keen to empower patients by exploring the introduction of more direct payments and personal budgets.

'In today's highly centralised NHS there is a democratic deficit, with too many decisions made in Whitehall,' Mr Lamb said.

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