Hamish Meldrum, chairman of the British Medical Association, and Laurence Buckman, chairman of the GPC, have said the BMA will step up its lobbying activity once the Health Bill has been published.

In response to an open letter calling for the BMA to withdraw its policy of “critical engagement” with the government over the NHS white paper, the two senior figures said the BMA has no intention of ceasing its pressure on the government.

In a letter published on the BMJ website, they say: “The BMA has no intention of ceasing its pressure on government to reconsider its position on the areas of most concern to the profession and patients.

"We will be stepping up our lobbying and member engagement activities once the Bill has been published and during its passage through parliament.”

However, it argues that: “By turning our back on the reform process now there is a danger that the changes continue but without the professional leadership that is so vital to ensure the highest standard of care for patients.”

It adds: “The consequences of not being involved would be far more damaging to the NHS we are seeking to protect and preserve."

The first, open letter was sent last week by Clive Peedell, a consultant clinical oncologist and BMA council member, and signed by more than 110 GPs.

It also called for a special representative meeting to allow the BMA membership to debate the proposals set out in ‘Equity and excellence: Liberating the NHS’; something the organisation has so far rejected.