400 medics have signed the following letter published in the Daily Telegraph today (hat tip to Liberal Conspiracy):

Dear Honourable Members of the House of Lords,

As public health doctors and specialists from within the NHS, academia and elsewhere, we write to express our concerns about the Health and Social Care Bill.

The Bill will do irreparable harm to the NHS, to individual patients and to society as a whole.

It ushers in a significantly heightened degree of commercialisation and marketisation that will fragment patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the health system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively and efficiently to communicable disease outbreaks and other public health emergencies.

While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms as a whole will disrupt, fragment and weaken the country's public health capabilities.

The government claims that the reforms have the backing of the health professions. They do not. Neither do they have the general support of the public.

It is our professional judgement that the Health and Social Care Bill will erode the NHS's ethical and cooperative foundations and that it will not deliver efficiency, quality, fairness or choice.

We therefore request that you reject passage of the Health and Social Care Bill.

Good for them.

And brave too. In a profession where those who step out of line are systematically bullied (as Dispatches showed last night) to sign such a letter takes real courage.

But Lansley will not, I am sure, have the courage to listen. I'm sure he's already planning his post-cabinet career. Now what might he be a consultant on, I wonder?