The health secretary, Andrew Lansley, said that he would delay the health bill "to pause, to listen and to engage with all those who want the NHS to succeed". He also promised changes to the plans. So what should Lansley do with the bill now?
British Medical Association
"There is so much in the bill that worries doctors that the ideal scenario would be to withdraw it altogether, and to work with stakeholders and patients to ensure the NHS is structured and delivered in the best way to meet the increasing demands on healthcare at a time of intense financial pressure," said Dr Hamish Meldrum, the BMA's chairman.
"If this is not possible, then the areas we would most like the government to amend concern competition. Under the legislation as it is currently written, the economic regulator, Monitor, would be given a legal duty to promote competition. We believe Monitor's key duty should be to ensure comprehensive and effective healthcare, and that alternative providers should only be used when the NHS does not have sufficient capacity.
"The concern about the proposals as they stand is that fear of being open to legal challenge could divert consortia from their key task of ensuring safe and effective care, and lead to fragmentation. Some existing NHS services – even those delivering high quality – could be at risk of arbitrary closure.
"Few NHS staff would argue against the government's stated aim of putting them 'in the driving seat'.
"The question is whether this bill would genuinely devolve power to the frontline, allowing clinicians to work together to give the most appropriate care to their patients.
"In fact, it would give the secretary of state and the new NHS Commissioning Board wide-ranging powers to intervene in day-to-day decisions on the way services are shaped, and even to dissolve consortia without consulting the public.
"Enforcing competition in this way would make it more difficult for clinicians to work together to ensure that the right services are available when patients need them.
The BMA supports the principle of clinician-led commissioning but believes it could be achieved without the need for further legislation.
"Countless organisations and experts have made clear their disquiet about the bill. There are now welcome signs that the government is listening and prepared to take on board their many concerns. The extent to which it is prepared to do so remains to be seen."
Royal College of GPs
Most health organisations do not think it is possible to tear up the bill and start again because the reforms are under way and many staff have already moved.
Clare Gerada, president of the Royal College of GPs, says the NHS reforms have reached a point where "things are safe at the moment", with primary care trusts (PCTs) merged into fewer "clusters" and embryonic GP consortiums under way.
"We should be rethinking relationships between primary, secondary and community care," she said. "Over the last four months, everybody started talking to each other, which is good. We should look at putting GPs on the boards of foundation trusts and getting consultants and nurses involved in clusters."
The "any willing provider" issue needed tackling, she said, with a presumption that the NHS providers would take precedence over others.
Except to abolish primary care trusts, she did not believe legislation was needed. "You should start with what you need to make things better for patients. That usually happens through clinician-to-clinician dialogue, supported by excellent managers."
NHS Confederation
In a report published last week, the confederation said the government should look at a multi-speed approach to the introduction of GP commissioning, better support for those GP consortiums that are ready to take on the commissioning role, and action on the use of competition and accountability.
"We are concerned about the best way to hold consortia accountable and are sceptical about whether, at a time when we are trying to reduce political interference in the NHS, placing local councillors on their boards [as some Liberal Democrat critics of the bill suggest] is the right way to go," said Nigel Edwards, acting chief executive.
"It should not be forgotten that the NHS is having to deal with the need to find £15bn-£20bn of savings over the next four years and the challenge of getting hospital trusts with in some cases real structural problems transferred to foundation trust status."
On their first days in charge, many GP consortiums may also be presented with controversial reconfiguration plans to decide upon, a more than challenging in-tray even for the most enthusiastic.
"What this reform process needs now is for the timetable to be reconsidered, for those consortia which are ready to go to be released from the starting gate, and for those that are not to be supported and worked with.
"The NHS, and the public, needs a narrative from government that demonstrates how these reforms will improve care for patients and which addresses genuine concerns rather than dismissing them."
Policy Exchange
The pace of the health reforms has to slow down – or the abolition of every primary care trust by 2013 could lead to the new structure replicating the old in all but name, said the rightwing thinktank Policy Exchange in its report, Implementing GP Commissioning. Good staff are already leaving ahead of abolition, it said.
GP consortiums need to be much smaller than PCTs to bring decisions closer to patients, but current projections on their size suggest nothing may change.
Clarification is needed on the way that private firms and the NHS will work together, or companies will decide it is not worth their while to engage. To ensure patients have absolute trust in their GP consortiums, their GPs should have to declare any gifts or hospitality they receive from providers of NHS care.
Health select committee
GP commissioning bodies should become NHS commissioning authorities – no longer comprising GPs alone, but including a social care professional, a nurse, a hospital doctor, a public health expert and an elected representative of the local authority. The select committee wants to help break down the barriers between primary care, hospitals and community care, but also points out that the consortiums will be responsible for spending large amounts of taxpayers' money.
It proposes a number of measures to ensure accountability, including an independent chair appointed by the NHS national commissioning board, meetings held in public, declarations of conflicts of interest and publication of papers. This governance structure would have to be the subject of secondary legislation, the report says.
If such tough governance measures are put in place, the select committee says GP consortiums should be able to commission dentistry and pharmacy services as well as general practice, which the bill does not currently allow because of potential conflicts of interest.
Labour
The opposition wants the health and social care bill scrapped. Ed Miliband called it "a bad bill, built on bad assumptions and dangerous ideology" and told David Cameron not to come back with "piecemeal changes".
Instead, Miliband said he wanted to see a new plan for the NHS based on the UK's health priorities, starting with "a decisive shift to a more preventative service … Family doctors should be expanding their role in helping people understand their risks, manage diseases and live healthier lives as we grow older."
Accountability was key, he said, and patients needed to know what they were entitled to. "Rather than being eroded, we should look at how we can strengthen national guarantees and entitlements," he said.
In a nutshell
How will the bill change the NHS? It gives GPs control of 80% of the NHS budget, £80bn a year, to form consortiums and commission services from April 2013, according to local needs. Primary care trusts and strategic health authorities will be scrapped. An NHS Commissioning Board will oversee the system.
Objections? Everybody wants to devolve power and money, but very many health bodies and doctors' organisations object to the speed of change, and to the detail: from potential conflicts of interest for GPs in making their commissioning choices, to hospitals maybe having to close departments because of quirky GP decisions.
Why 'privatisation by the back door'? Consortiums can commission from "any willing provider", which may well be a company. However, Andrew Lansley recently stated that NHS employees who form a social enterprise to provide services will get preferential treatment, at least to begin with.
Why bring in Cameron and Clegg? They say that the ideas are good, but the public has not yet bought in – code for vociferous opposition all round.
How much will it cost? £1.4bn, but ministers hope to save £5bn by 2015 through reorganised care and redundancies among NHS managers.
The committee man – Stephen Dorrell
Stephen Dorrell knows where the bodies get buried. As a former health secretary in John Major's government from 1995 to 1997, he has experience of dealing with medical royal colleges, thinktanks, trade unions and other health bodies, and he is unfazed by the complexities of the NHS. Many people think he would be delighted to occupy the health secretary's office once more, should Lansley vacate it.
Dorrell was elected in June last year as chair of the health select committee by a House of Commons well aware of his expertise, and he has shown every sign of relishing the role and the opportunity it gives him to probe government policy, albeit in "critical friend" mode.
Two committee reports into NHS commissioning have been less than helpful to Lansley, pointing out first how the plans for reform appeared out of the blue – they were not in the coalition agreement – and then suggesting fairly substantial changes.
Dorrell has cast himself as the wise elder statesman, leaving more outspoken committee members, such as GP Sarah Wollaston, to lambast Lansley's policies.
The NHS chief
The growing pressure in recent weeks on the coalition over its health plans has seen David Nicholson, chief executive of the NHS since September 2006, become the man David Cameron listens to most closely and trusts to help rework the proposed reforms so they damage neither the health service nor the government.
Nicholson's increasingly influential role is testament to the skills, honesty and deep knowledge of the NHS of someone who has spent more than 30 years in the service, mostly in leadership roles. Some expected Andrew Lansley to dispense with the services of the one-time communist when he took office last May. Instead, Nicholson survived and is now acting as a source of wise counsel for No 10.
Where Lansley is dogmatic and slow to acknowledge any imperfection in his NHS masterplan, Nicholson is much more pragmatic. Noted for his candour, he has used his position to raise issues of concern both privately and publicly. He is strongly opposed to NHS care being opened up to "any willing provider" – a key element of Lansley's plan, which Downing Street now worries has left ministers vulnerable on the charge that they are privatising the NHS, and also concerned that, in the melee of a radical restructure, the NHS finances will get out of control.