NHS 'in peril' if health reforms fail, warn GPs However, many believe the real motive is to open up the NHS for greater private sector involvement. Last November the BMA moved to a position of total opposition to the Bill, and since the New Year the Royal College of Nurses and the Royal College of Midwives have followed suit. The Royal College of GPs is deeply sceptical, although not yet publicly in total opposition. However, some BMA members are deeply unhappy at its stance, which is reflected in the letter. It notes: "Blanket opposition to the NHS reforms by the British Medical Association and the Royal College of Nurses is not representative of the views of GPs who, like us, already lead CCGs, and the large numbers of GPs and nurses who support us." The letter was organised by the NHS Alliance, which describes itself as "an independent non-political organisation proud to be at the forefront of clinically-led commissioning." Dr Shane Gordon, chief executive of North East Essex CCG, who helped draft the letter, said: "The BMA and RCN have strong and respected voices within the profession, but a range of views is vital to a rounded discussion. As leaders of CCGs, who have already tried and tested some of the principles of the NHS reforms, we are united in our view that clinical leadership of commissioning is essential to the future of the NHS. Dr Laurence Buckman, chairman of the BMA's GPs Committee, said if the reforms were just about commissioning "the BMA would be in favour." But he added: "However, they are not; the wider reform agenda will make the improvements these CCG leads, quite rightly, want to make to patient care, harder rather than easier to achieve." Dr Clare Gerada, chair of the RCGPs, said: "GPs must understand their role in commissioning and we support the principle of greater clinician involvement. But many of our members feel that this could have been done in a less disruptive way by placing GPs on the boards of existing PCTs. Most GPs would struggle to find the time to "play a major part" in commissioning, she added, while the Bill "also brings an emphasis on competition and the removal of Governmental responsibility, which we feel will result in an adverse effect on quality of care and patient safety."