Councillors have agreed to refer controversial maternity changes to the Secretary of State - but have approved the rest of the proposed health reforms.

Members have been taking health bosses to task about the plans they approved and how the changes to maternity and paediatrics will impact on women, children and families.

Councillors on the Cumbria Health Scrutiny Committee this morning voted in favour of using their powers to call in some of the decisions made by NHS Cumbria Clinical Commissioning Group, but later u-turned on the call for all but maternity services.

When the second vote was taken, only seven of the 11 committee members were still at the meeting.

The first item members quizzed health bosses on was paediatrics - specifically plans to downgrade the children's ward in Whitehaven so only low risk patients could be cared for there. There would be overnight beds, but only for monitoring.

Members raised concerns about sending children more than 40 miles from home at night, and asked whether there were enough ambulance resources to cope with the extra transfers.

Raymond Gill, Copeland district councillor, questioned the distances being quoted, saying for patients south of Whitehaven it could actually be 50 or even 60 miles to Carlisle.

Alan Toole, independent county councillor, accused bosses of "creative accounting" after they suggested the numbers of extra children being transferred would be roughly four a week. He said in actual fact some weeks could be far busier than others.

Copeland councillor Gillian Troughton, a volunteer driver with St John Ambulance, also said the figures used do not take into account the number of children currently going to A&E and not admitted.

She said most of west Cumbria's parents would not be able to get to Carlisle A&E out of hours so would have no choice but to call an ambulance.

Mrs Troughton said she personally knew of 10 children this month that this would have happened to.

Members said there is also confusion about the dedicated ambulance proposed, who could use it and how it would be staffed.

Christine Wharrier, Whitehaven county councillor, proposed that the paediatrics decision is referred to the health secretary and has been backed by the majority of members. The vote was carried 8-3.

However, when the remaining councillors voted again at the end of the day, after discussions with health bosses, they instead opted not to call the paediatrics decision in.

Councillors then moved on to the plans for maternity.

Members were concerned about the decision taken by the CCG, which gives consultant-led maternity a 12-month reprieve to tackle recruitment problems.

But if deemed unsuccessful, the body could press ahead and remove consultants - or potentially all births - from the West Cumberland Hospital without further consultation.

Members asked for clarity on whether, if this was the case, 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 to the Secretary of State, with only Conservative county councillor John Lister against.

This vote was upheld at the end of the day, and so Health Secretary Jeremy Hunt will be called upon to make the final decision.

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.

The CCG had agreed a caveat to work with the affected communities over the next 12 months, to fully explore all of the alternatives.

But despite assurances that there would be no closures until this happens and care in the community improves, scrutiny committee members voted 10-0 in favour of calling the matter in, with one abstention. This was another decision they changed their minds on.

Concerns included the lack of alternative care, with home care and care home places in short supply, and the impact the removal of medical beds would have on the provision end of life care in the affected communities.

Members also felt that closing community beds would fuel bed blocking in the Carlisle and Whitehaven hospitals, and would leave some patients far from home with poor or in some cases no public transport for family members.

Eden district councillor Virginia Taylor said there was also insufficient consideration of way other local health services rely on medical beds, for example the GP practice in Alston that would struggle to stay afloat without them.

She also also criticised the CCG for failing to commission an independent review on community hospital provision before deciding to close beds.

Members were also critical that the decision to remove medical beds limits the alternative options that can now be drawn up by communities.

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

Members will also not contest A&E plans, emergency surgery, trauma and orthopaedics.