Doctors' leaders have issued an extraordinary appeal to David Cameron for a truce in their vitriolic battle over the Government's health reforms.
In a personal letter to the Prime Minister, the head of the Royal College of GPs, one of the organisations most vociferously opposed to the Bill, has called for talks on how to implement the legislation. The move, which will dismay other opponents of the reforms, comes as the Bill returns to the House of Lords today. It is also due to be discussed in the Commons after Labour forced an opposition day debate.
In the letter, sent last week, the College's chair, Clare Gerada, tells Mr Cameron that she understands his "passion" for the NHS, and states: "Now is the time to restate our similarities rather than continually focus on our differences". She says she wants to help him "find a way through the tensions" and adds that she is writing in the "hope that we can find an acceptable way forward in which the Royal College of GPs is able to work with the Government towards the future stability of the NHS."
The letter appears to mark a volte-face for the RCGP and Dr Gerada, who has been one of the most strident critics of the health reforms. In a letter to the Government just a month ago, she wrote that the Health and Social Care Bill would "cause irreparable damage to patient care".
She also called on Mr Cameron to "halt this damaging, unnecessary and expensive reorganisation which risks leaving the poorest and most vulnerable in society to bear the brunt".
The new letter merely states that the College's position on the Bill is "consistent" and that it does not agree on the need and impact of "parts of the proposed legislation". However, it adds that the College wants to "work together" to make the health service "secure, stable and safe".
The change in stance is believed to have followed meetings between senior members of the RCGP Council, who feared the organisation was becoming "alienated" from the Government over its position on the Bill. They told Dr Gerada – with the Bill likely to become law in the next few months – that the College had "lost its place at the table" as a result of its strident opposition.
Last month the RCGP was pointedly not invited to a round-table discussion of health professionals in Downing Street. Several groups of doctors are known to have contacted the college, calling for it to tone down its opposition. In one letter, marked "Private and Confidential" and seen by The Independent, a group of doctors in Lancashire said if the work done on implementing the health reforms was to be scrapped now it "would be both reckless and dangerous".
"We feel [the RCGP's position] neither represents the views of those members directly involved in the creation and development of clinical commissioning groups nor helps to motivate them," they wrote.
Other senior doctors have become concerned by the increasingly vitriolic nature of the debate over the Health Bill. Yesterday the British Medical Association (BMA) distanced itself from a member of its own governing council, Clive Peedell, after he launched a Twitter campaign against the Liberal Democrat peer Shirley Williams.
"Can all Twitter NHS staff please state: 'Shirley Williams is no friend of the NHS and no friend of mine'," he wrote after Baroness Williams supported a motion at the Liberal Democrat Spring Conference backing the amended health reforms. The BMA said Dr Peedell was "expressing his views as an individual".
Dr Gerada said she had written to Mr Cameron because if the Health Bill does pass "it will need to be implemented and we can still have an influence on it". She said she felt the debate had become "so polarised" and was concerned that the GCGP had been excluded from Downing Street last month.
"In some ways you are damned if you do and damned if you don't," she said. "But our members have to make the Health Bill work. We are not a trade union and will have to make whatever happens work for our patients."
She added that the vast majority of her members who contacted her still supported the College's opposition to the Bill – but the emollient language of the letter will still surprise some of those most opposed to it. She writes: "We both share a passion for the NHS and we all want to find a way of improving it."
She ends: "We hope that, at the right time, you would feel able to meet to consider how the College can contribute to the issues we have in common."
Downing Street last night refused to comment on the letter and referred inquiries to the Department of Health. It said the Government was formulating a response.