Opposition to the government’s reforms of the NHS reached a crescendo in the second half of December as doctors, politicians, and health policy analysts all went on the offensive.

The wisdom of the changes—to replace primary care trusts with GP led commissioning consortiums and to have the new bodies operating by April 2013—was questioned by numerous diverse sources. The criticisms came in the same week that the government published its response to the consultation on its white paper Equity and Excellence: Liberating the NHS by declaring that the reforms would go ahead with minimal change.

More than 200 clinicians signed a joint letter published in the Times on 13 December warning that the government’s plans would “destroy” the NHS (BMJ 2010;341:c7224, doi:10.1136/bmj.c7224).

The letter, signed by 206 medical professionals, said that the desire of England’s health secretary, Andrew Lansley, to put patients at the heart of care and involve clinicians in decisions about service provision could be achieved without the “massive structural upheaval” …