Doctors urge the Government to abandon health reform Bill By Jeremy Laurance

 Doctors' leaders yesterday stopped short of a vote of no confidence in Health Secretary Andrew Lansley but demanded that he halt his plans to reform the NHS and condemned his failure to act on their concerns.

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     Andrew Lansley is looking increasingly friendless in the chorus of criticism against his health reforms.

 In what is turning out to be a torrid week for the Health Secretary, the British Medical Association (BMA) called on him to withdraw the Health and Social Care Bill, now going through Parliament, and warned that it would lead to the "fragmentation" and "privatisation" of the NHS.  

 However, the BMA failed to back a vote of no confidence and stopped short of condemning its leadership for pursuing a policy of "critical engagement" with the Government rather than outright opposition to the Bill, after an appeal from the chairman, Hamish Meldrum, not to "tie our hands".

 The emergency meeting in London – the first of its kind for almost 20 years – was attended by more than 300 doctors representing BMA divisions across the country. It came two days after the Liberal Democrats rejected the Government's plans, which will see GPs take control of £80bn of NHS spending and an escalation of market competition and private provision of services, at the party's spring conference last weekend.

 Mr Lansley is looking increasingly friendless as health economists, NHS managers, think-tanks, the unions and the Commons health select committee have joined the chorus of criticism of the reforms. He promised concessions to his critics after the Liberal Democrat vote at the weekend, but doubts have been raised over whether these would be more than cosmetic after the Prime Minister's official spokesman said there would be "no significant changes" to the policy in the Bill.

 While the Government would have little difficulty in getting the reforms through the Commons intact, despite Liberal Democrat reservations, Mr Lansley would run the risk of them falling in the Lords to a charge led by Baroness Shirley Williams, a key mover of last weekend's vote.

 Labour yesterday sought to capitalise on Mr Lansley's difficulties by tabling amendments to the Bill to protect the NHS against the introduction of a full-blown competitive market and launching a petition to protect frontline services.

 The scale of the challenge was highlighted yesterday by the Public Accounts Committee, which said productivity had declined in the NHS by an average of 0.2 per cent a year over the past decade, a period of record growth, but now faced demands for a 4 per cent a year productivity gain to achieve £20bn of savings by 2014-15.

 The BMA attacked plans to increase competition and the market, saying it would weaken co-operation, inflate costs, undermine hospitals and favour commercial companies.

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Vital Accounts: Quantifying Health and Population in Eighteenth-Century England and France (Cambridge Studies in the History of Medicine)