In a letter to the prime minister, the college warned that it fears the Bill ‘will cause irreparable damage to patient care and jeopardise the NHS’.

An RCGP poll last month found that 98% of its members would back a call for the Bill to be scrapped, but the college initially resisted the move.

However, after amendments to the Bill announced this week in the House of Lords, RCGP leaders went over the head of health secretary Andrew Lansley, voicing concerns directly to Downing Street.

RCGP chairwoman Dr Clare Gerada said: ‘This decision was not taken lightly, but it is clear that the college has been left with no alternative. We have taken every opportunity to neg­otiate changes for the good of our patients and for the continued stability of the NHS, yet while the government has claimed that it has made widespread concessions, our view is that the amendments have created greater confusion. We remain unconvinced that the Bill will improve the care and services we provide to our patients.

‘Competition, and the opening up of our NHS to any qualified providers will lead not only to fragmentation of care, but also potentially to a "two-tier" system with access to care def­ined by a patient’s ability to pay.’

She called for PCT clusters to have GP-led boards, and backed a greater role for GPs in commissioning. ‘We must raise our concerns in the hope that the prime minister will halt this damaging, unnecessary and expensive reorganisation which, in our view, risks leaving the poorest and most vulnerable in society to bear the brunt.

Dr Gerada added: 'We will continue to do everything we can, both as a College and in partnership with our colleagues in the Academy of Royal Colleges, our nursing colleagues and across the wider health and social care sectors, to bring about change for the good of our patients and preserve the principles of the NHS that has served millions of patients so well for over 60 years - a universal healthcare service, free at the point of need.'

BMA chairman Dr Hamish Meldrum said: 'The RCGP statement seeking withdrawal of the Health Bill surely scotches, once and for all, the government's claims that there is professional support for this deeply flawed, damaging and unnecessary legislation.

'Whilst GPs and other clinicians support the concept of clinically-led commissioning, they do not believe that this expensive upheaval of the health service is needed to achieve that. If the prime minister really wants to put clinicians in control he should listen to what they are saying - louder and louder each day - and put this increasingly confused legislation out of its misery.'

Meanwhile health minister Simon Burns launched an attack on the RCGP, calling its opposition 'baffling'.

 

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