The coalition's plans to shake up the NHS are facing another battering as ministers assess the impact of last week's local elections.
Deputy prime minister and Liberal Democrat leader Nick Clegg is hoping to secure substantial changes to health secretary Andrew Lansley's reforms.
The health and social care bill implementing the shift to a market dynamic based on commissioning of services by GP consortia has been paused while the coalition reconsiders.
That has only encouraged campaigners, including much of the NHS workforce which is opposed to the changes.
The Royal College of General Practitioners has written a letter to prime minister David Cameron warning that the plans could fundamentally undermine the NHS if they are not substantially overhauled.