The British Medical Association is piling on pressure on the government to scrap large parts of its health and social care bill, in particular those relating to competition, but has stopped short of opposing it altogether.
Following an emergency meeting of representatives last week to better define its battle lines, BMA council chairman Hamish Meldrum wrote to health secretary Andrew Lansley outlining the union's "grave concern about major elements of the bill", as well as calls for its withdrawal to improve proposals for the benefit of "patients, the profession and the NHS".
Perhaps its greatest bug bear, the Association has slammed plans to give new economic regulator Monitor powers to ensure the promotion of competition, which the vast majority of doctors believe will "lead to a fragmentation of care and will undermine commissioning consortia’s ability to make decisions based on the best interests of their patients and local populations".
As it steps opposition up a gear the BMA said it will continue to publicise criticism of the most damaging parts of the bill, under which GP-led consortia are to be handed commissioning powers while Strategic Health Authorities/Primary Care Trusts are wiped from the system, opening up the field to competition.
One thing is clear - the government has thus ailed to secure significant support from the frontline. "The government should not be left in any doubt about the strength of feeling among the medical profession; many doctors recognise the need to change how the NHS is run but have serious concerns about scale and nature of the planned reforms which are hugely risky and, potentially, highly damaging,” Meldrum stressed.
Meanwhile, it has emerged that the Liberal Democrats aren't entirely happy with certain aspects of the health bill either.
According to a report in The Guardian, the party is seeking to make amendments to the bill before it reaches the report phase, with Norman Lamb rumoured to be heading up negotiations.
Its proposals are likely to hinge on safeguards to prevent the private sector from cherry-picking the most lucrative contracts, ensuring that locally-elected councillors sit on GP commissioning boards, as well as plans for the new economic regulator, Monitor, it said.
Opposition also came from the Tory corner last week, after MP Sarah Wollaston told the Sunday Telegraph that the NHS could be "changed beyond all recognition" if Monitor "is filled with competition economists with a zeal for imposing competition at every opportunity".
"It is no use 'liberating' the NHS from top down political control only to shackle it to an unelected economic regulator," she argues.