Burnley Liberal Democrat MP Gordon Birtwistle voted in favour of the Government's controversial health reforms yesterday.

The Health and Social Care Bill received its third reading by 316 votes to 251, Government majority 65.

The bill has now cleared the Commons but ministers will be braced for further difficulties in the House of Lords.

Prime Minister David Cameron insisted the shake-up would create a "stronger NHS" and improve patient outcomes.

Speaking at Prime Minister's Questions, he said: "The point of our health reforms is to put doctors in charge, give patients greater choice and heal the divide between health and social care."

But shadow health secretary John Healey said: "It's reckless to force through the biggest reorganisation in NHS history at the same time that finances are tight and pressures on the health service are growing.

"These are the wrong reforms, at the wrong time, driven by the wrong ideology."

The reforms have endured a rough ride, with progress on the plans "paused" earlier this year following criticism from health professionals and patients groups.

Following a "listening exercise" the Bill was sent back to committee in the Commons for a series of revisions, including giving health professionals other than GPs power over how NHS funds are spent, stronger safeguards against a market free-for-all and scrapping a 2013 deadline for the introduction of new commissioning groups.

But as well as facing opposition from Labour and creating concerns for the unions and medical royal colleges, the plans have also exposed fault lines within the coalition.

However, only four Lib Dems rebelled and voted against the Bill at third reading.

Now the Bill has cleared the Commons it heads to the Lords, where Lib Dem grandee Baroness Williams is set to play a major role.

She has said she still has concerns over the influence of the private sector and warned the "battle is far from over".