People who turn up drunk at A&E and abuse NHS staff could be fined or banned from local pubs under proposals floated today by a Norfolk MP.

People who turn up drunk at A&E and abuse NHS staff could be fined or banned from local pubs under proposals floated today by a Norfolk MP.

The proposal forms part of a "liberal blueprint for the NHS" which would also see a range of health quangos abolished and the devolution of cash-raising and spending powers to elected local health boards.

Under Liberal democrats health spokesman and North Norfolk MP Norman Lamb's blueprint - which is not yet official Lib Dem policy - the boards would replace unelected Primary Care Trusts and be given a statutory duty to secure both quality and value for money for local people by sourcing health care from NHS, private or voluntary providers.

Granting local boards financial and political responsibility would provide a direct incentive to improve efficiency and allow a large reduction in the size of central NHS bureaucracy, he said.

Mr Lamb called for the abolition of Strategic Health Authorities, along with quangos including the National Patient Safety Agency, Independent Reconfiguration Panel, National Treatment Agency and Connecting for Health and said that the massive NHS IT programme should be scaled back.

Salaries for the top management health quangos should also be reviewed, said Mr Lamb, pointing out that 19 out of 23 chief executives earnt six-figure sums last year, while the total paid to chairs and chief executives topped �5 million.

He also proposed reforms to the "payment by results' system, so that hospitals receive no payment at all if a patient picks up a superbug infection, is given the wrong medication or suffers deep-vein thrombosis while in their care.

Patients should be granted an "individual entitlement to treatment', requiring the health board to pay for them to go private if they are not treated on time, said Mr Lamb.

Decision-making powers should be devolved to the professionals closest to the patients and staff in hospitals should be allowed to vote on becoming a John Lewis-style wholly-owned employee trust.

GP pay should be linked to improvements in patients' lifestyle, like giving up smoking or losing weight, and patients should be given the right to contact their family doctor by email, said the Lib Dem blueprint.

And it suggested that patients who abuse or threaten staff while drunk could be sent a bill following treatment or be banned from local pubs and clubs for a period of time.

Mr Lamb said: 'These proposals set out a liberal approach to the NHS which can drastically reduce costs, improve the quality of care and give people a say in how their local services are run.'