Doctors have overwhelmingly supported a motion of no confidence in the health secretary, in a move which is likely to further distance NHS workers from the government.
Delegates at the British Medical Association's (BMA) annual conference backed the motion against Jeremy Hunt so strongly there was no need to even hold a vote.
"His main purpose seems to be criticising the service and undermining the staff," said Jacky Davis, a hospital consultant and member of the BMA's ruling council, as she proposed the motion.
"He is at the forefront of a new political blame game, blaming frontline NHS staff for the predictable chaos resulting from his government's reforms and cuts."
In a rare move, the leader of the doctor's union, Mark Porter, endorsed the motion, suggesting channels of communication between doctors' leaders and the government have broken down.
"This vote is a crushing personal defeat for David Cameron and Jeremy Hunt - and a government who promised to listen to doctors," shadow health ministe Andrew Gwynne said.
The BMA held a vote of no confidence against former health secretary Andrew Lansley after his NHS reforms caused outrage among medical professionals.
Hunt, who has been implementing the reforms, is not much more popular than his predecessor.
His various attacks on "coasting" hospitals and mediocre care have angered professionals. He has been criticised for singling out nurses for sub-standard care and pushing family doctors to engage in out-of-hours cars.
The timing of the BMA motion is not ideal, however. With the newspapers full of allegations of a cover-up at the Care Quality Commission over care at Morecambe Bay, the public may be less sympathetic to doctors' leaders than they were when debate centred on NHS reform.
Public opinion about medical care also hardened after details emerged of the regime at Mid Staffordshire which caused hundreds of needless deaths.