By Ian Dunt
Groups representing the doctors who are supposed to handle commissioning under NHS reform have been excluded from talks in Downing Street today because of their opposition to the policy.
The British Medical Association (BMA) and the Royal College of General Practitioners, who have long opposed Andrew Lansley's reforms, have not been invited to the event.
"I don't think it's odd at all because this is part of an ongoing dialogue," health minister Simon Burns insisted.
"We have had hundreds of meetings. There have been thousands of people involved in talking and looking into ways of improving and engaging on the health bill.
"We are on this occasion meeting those organisations who are constructively engaged in implementing the modernisation."
Downing Street insisted the widespread opposition of doctors, many of whom would be asked to take a leading role in NHS organisation under the reforms, was counter-balanced by the fact GPs throughout the country were already implementing the changes.
But opponents are furious that events are already changing on the ground, despite the lack of parliamentary mandate.
"It may sound like a small point to David Cameron but I wish to remind him that he doesn't yet have parliament's permission to implement reforms nobody wants and for which no-one voted," shadow health secretary Andy Burnham said.
"This has all the hallmarks of an event thrown together in a last-ditch desperate bid to shore up collapsing support for the bill.
"It would appear to be so last-minute that a number of important organisations have been left off the invite list, or maybe it's because the PM wouldn't like what they've got to say."
The BMA said: "It would seem odd if the major bodies representing health professionals were not included."
The Royal College of Physicians is holding an extraordinary general meeting in London on February 27th to discuss whether it should ask its members' view on the bill. Some reports suggest the government is putting extraordinary pressure on the group to back the bill.
The Royal College of Surgeons has supported the bill throughout. Both groups have been invited to today's event.
"He is clearly trying a policy of divide and rule in the hope that he can break the opposition to the bill by only asking those he believes will support him," former foreign secretary and doctor Lord Owen told the Guardian.
"The prime minister may think he can outmanoeuvre or override the BMA in the same way that Clement Attlee and Aneurin Bevan did when the 1945 Labour government introduced the National Health Service in the face of opposition of the BMA.
"But the BMA in 1946 was much more evenly divided than they are now and Attlee had a clear electoral mandate from the British people to push through his reforms – something Cameron does not have."
The pressure over the government's NHS reforms is unlikely to die down this week, with Labour holding a parliamentary debate on the publication of a risk register listing the potential dangers of continuing to pursue the reforms.
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