Controversy erupted at the end of a key meeting which saw councillors vote for, and then backtrack over, whether or not to refer crucial health decisions to the Secretary of State.

Members of the Cumbria Health Scrutiny Committee met yesterday to determine if they should use powers to "call in" the health reforms agreed by NHS Cumbria Clinical Commissioning Group .

This would mean they would be referred to Health Secretary Jeremy Hunt, who could potentially order an independent review.

Initially members voted in favour of referring the decisions to downgrade paediatrics at the West Cumberland Hospital , remove beds from three of the area's community hospitals and potentially centralise consultant-led maternity services in Carlisle.

But, following further discussions with health bosses, the final formal vote saw some councillors - minus four of the original 11, who left before the end - change their stance.

As a result only the maternity decision will now be referred to Mr Hunt.

Prior to the meeting, campaigners had urged the scrutiny committee, made up of county and district councillors, to call in all of the CCG decisions.

The day-long meeting, in Carlisle, started with members taking bosses to task on the decision to downgrade children's services in Whitehaven and give maternity just 12 months to tackle major recruitment issues before centralising consultant-led maternity - or potentially all births - in Carlisle.

For paediatrics, members raised concerns about sending children 40 miles to Carlisle at night, or further for those living south of Whitehaven, and whether there were enough ambulances to cope.

There were also concerns about the numbers of children being quoted by the CCG.

Alan Toole, an independent county councillor for Carlisle, accused bosses of "creative accounting" for estimating it would be four a week, while Copeland councillor Gillian Troughton, a volunteer driver with St John Ambulance, said many would not be able to get to Carlisle out of hours so would call an ambulance - adding she personally knew of 10 children this month that this would have happened to.

Christine Wharrier, Whitehaven county councillor, proposed it be referred to the health secretary and the initial vote was carried 8-3.

However, when the formal vote was cast at the end of the day, they backtracked. This time the vote was 5-2 against referring it on, with only Mrs Wharrier and Mr Toole in favour.

It followed a guarantee that the CCG would carry out an independent audit of the new measures, focusing on safety.

Asked why she controversially changed her stance, Mrs Troughton told the News & Star: "It was about the safety issue. I was wavering but that audit has reassured me that the service will be safe. I do not need the Secretary of State to tell me that. I just want kids in Cumbria to be safe."

However, speaking afterwards, an angry Mrs Wharrier said she was "very disappointed" at change of stance. "I think (the CCG) have been very lucky today," she added.

On maternity, members asked bosses for clarity on whether, should the CCG decide consultant-led maternity in Whitehaven is not sustainable after 12 months, it would come back before the scrutiny committee for further questioning and debate. However they did not feel they received such confirmation and voted 10-1 in favour of referring the matter, with only Aspatria county councillor Jim Lister against.

Despite bosses later trying to offer further reassurances, the second vote saw it again passed 6-1. It will therefore be formally referred to the health secretary for further scrutiny.

A decision to close community hospital beds in Maryport, Alston and Wigton also looked likely to be referred to the health secretary until a last minute change of heart.

Despite a pledge to continue working with local communities on viable long term alternatives, concerns remained.

These included the lack of home care and care home places, transport issues for those living in isolated areas, the impact on end of life care, fears that cuts would further fuel bed blocking in the Carlisle and Whitehaven hospitals, and that the decision to remove medical beds limits the alternative options that can now be drawn up.

The committee initially voted 10-0 in favour of calling the matter in, with one abstention. But later in the day, members changed their stance following assurances that no beds would close until alternative care was in place, that any money saved would be reinvested locally and bosses reaffirming their commitment to work with each community to find innovative new ways of providing better care.

The final vote was 4-3, with Mrs Wharrier, Mr Lister, Mrs Troughton and Carlisle councillor Jessica Riddle voting against referral and chairman Neil Hughes, Eden councillor Virginia Taylor and Mr Toole in favour.

This time Mrs Wharrier explained why she changed her stance from the initial vote, saying she was convinced that there was a genuine will to come up with the alternatives promised. "I think it can work and could work a lot better," she said.

The scrutiny committee raised some concerns about centralising stroke care in Carlisle due to extra distances, but accepted that the current service is not good enough. Nobody proposed calling this decision in.

Members also decided not contest to plans for A&E plans or emergency surgery, trauma and orthopaedics.