By Cassie Chambers
Doctors have passed a motion of no confidence against health secretary Andrew Lansley.
The British Medical Association (BMA) ignored calls from its leadership to reject the motion by narrowly passing it earlier today.
The issue was hotly contested and narrowly decided: 158 delegates voted in favour of the measure and 124 voted against it.
The Labour party said the vote was indicative of the government's failure to deliver effective health policy.
"This vote is a crushing personal defeat for a Health Secretary," shadow health secretary Andy Burnham said.
He continued: "The NHS is only as good as the people who work in it. The prime minister urgently needs to change direction - he should also ask himself whether it is wise to leave in position, at this critical moment, someone who has so obviously lost the confidence of the professions."
The vote comes on the heels of last week's historic day of industrial action by the NHS, whereby doctors boycotted non-acute care as a way of expressing their dissatisfaction with the government's proposed changes to their pension funds.
Doctors say the changes disproportionately impact their field, as physicians will see their contributions to pension funds rise more than other public sector employees.
"We will fight back, we will fight hard and we will fight for as long as it takes us to get fair treatment," said Dr Kevin Kane, an acute medicine consultant from London.
Yet other members of the BMA urged caution moving forward, suggesting that doctors may lose the trust of the public if they move too quickly or radically.
Dr Hamish Meldrum, the outgoing chair of the BMA, used his final speech on Monday to urge doctors to find a "sensible way out" of the dispute with the government.
Upon presenting the motion to the meeting, Dr Gary Marlow said: "I know there will be the argument that we should not call for someone to resign with whom we might have to negotiate tomorrow but he doesn't listen anyway so that is no argument."
"I do not trust this man, [Lansley]," he continued.
Later today the BMA will consider the question of how to move forward in its pension struggle against the government.
A policy passed at the members' meeting earlier this week gave the BMA increased powers to strike, perhaps suggesting more industrial action has not yet been taken off of the table.