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by Ray Fleming

There were strenuous efforts made by No 10 Downing Street yesterday morning to downplay the importance of the meeting convened by the prime minister to discuss the implementation of the government's National Health Service reforms. It was not a “summit”, said a spokesman, just one of a number of routine consultations with NHS professionals which Mr Cameron would attend. But however the meeting is described the basic fact about is that the bodies representing the majority of those affected by and most concerned about the reforms -- the Royal College of Nursing, the Royal College of General Practioners and the British Medical Association -- were not invited.

On BBC Radio Four's Today programme the Health Minister (Simon Burns, in case his name escapes you) said that those attending the meeting were “constructively engaged in implementing NHS modernisation” but the Royal College of Nursing would be absent because it was not “constructively engaged”. No 10 and Andrew Lansley, Secretary of State for Health, speak as if the Bill on which these reforms depend is already law. It is not and it may not be until it has been amended considerably by the House of Lords and the Commons. Furthermore, the upcoming Spring meeting of the Liberal Democrats, at which last year there was an influential vote of no confidence in the NHS proposals, may make its views known again.