The government has tabled a series of amendments to the Health and Social Care Bill ahead of its return to the House of Lords on February 8, but critics say the Bill remains fundamentally flawed and must be withdrawn.
The amendments - which deal with the responsibilities and accountability of the Health Secretary, greater patient involvement, education and training, health inequalities and strengthening integration - have been tabled as a result of Ministers "carefully listening to the ideas raised as the Bill has progressed through Parliament," said Health Secretary Andrew Lansley.
However, they have failed to satisfy the Royal College of General Practitioners (RCGP) and the British Medical Association (BMA), who are calling for the Bill to be scrapped altogether.
Despite the number and extent of the amendments, the RCGP says it "remains concerned that the Bill will cause irreparable damage to patient care and jeopardise the NHS," and has called on Prime Minister David Cameron to "halt this damaging, unnecessary and expensive reorganisation."
The decision to call on Mr Cameron for the Bill's complete withdrawal was not taken lightly, but it is clear that the College "has been left with no alternative," said RCGP chair Dr Clare Gerada.
"We support a greater role for GPs in the planning design and delivery of services within their local communities, but as the organisation representing the views of over 44,000 GPs, we cannot support a Bill that will damage the care and services that GPs deliver to patients and ultimately bring about the demise of a unified, national health service," she said.
The BMA has welcomed the College's decision, saying that it "surely scotches, once and for all, the government's claims that there is professional support for this deeply-flawed, damaging and unnecessary legislation."
The amendments are "little more than minor tweaking" which do little to address the issues which continue to cause the BMA great concern, said Dr Hamish Meldrum, chairman of BMA Council. For example, he said, "an over-reliance on market forces remains at the core of the Bill, there is excessive control over commissioning groups, plans for incentives for commissioning are ill-thought through, and proposals to give hospitals more scope to generate income from private patients pose serious risks.”
"The government has had to make so many amendments to remedy the initial flaws in the legislation and has brought in so many checks and balances that the level of complexity and bureaucracy in the new NHS will be huge. It would be better to withdraw the Bill altogether and come up with a new plan," Dr Meldrum suggests.
As it enters its Report Stage in the Lords, he pointed out to peers that "many of the things the government wants, such as clinician-led commissioning, do not require legislation and can be achieved without further structural change."
"If the Prime Minister really wants to put clinicians in control, he should listen to what they are saying - louder and louder each day - and put this increasingly confused legislation out of its misery," said Dr Meldrum.
Labour leader Ed Miliband has also called for the Bill to be scrapped. Speaking yesterday (February 6), he said that the funds which the government has set aside for the costs of its reorganisation would be more than sufficient to protect all 6,000 nursing jobs which could be lost by the end of this Parliament since the General Election.
Shadow Health Secretary Andy Burnham added that it was "reckless in the extreme to plough on with this reorganisation when organisations that represent 1.2 million NHS staff are lined up against it."