As opposition to the Health and Social Care Bill intensifies, there is now a real feeling that the reforms might be in genuine danger.
If the bill does not receive Royal Assent by the state opening of parliament in May, it will be 'effectively dead', the DoH acknowledges, requiring re-submission to parliament.
In the run up to this week's second reading of the bill in the House of Lords, an open letter in the Daily Telegraph from 365 public health experts warned the bill would 'derail and fragment the NHS into a collection of competing providers'.
It argued that the 56 GP commissioning leads who wrote to the paper in support of the bill 'do not represent the majority of GPs who believe the bill will seriously damage patient care'.
This is supported by a YouGov poll in the Sunday Times which showed that 65% of NHS workers want the bill withdrawn, 66% believe it will make the NHS worse and 84% are concerned about the role of the private sector.
The renewed clamour shows the importance of joined-up, integrated thinking and action. It is the combined efforts of the Royal Colleges, declaring outright opposition to the bill, that has put real pressure on the health secretary; this was backed last week by healthcare editors who ran joint editorials opposing the bill.
In the BMJ, Kieran Walshe, professor of health policy and management at Manchester Business School, said abandoning the Health Bill would save £1billion in 2013, while allowing ministers to accomplish much of the reform agenda using existing legislative provisions.
Ministers' failure to meet May's deadline would be a victory of sorts for health professionals who, contrary to some reports, are not opposing reforms in retaliation for pension changes. However, a bill resubmitted in May could leave the NHS in a state of limbo; ministers must avoid this by making real changes now to their unpopular, unproven reforms.