David Cameron will today signal his determination to press ahead with health reforms as he stages a Downing Street summit from which critics of the plans have been excluded.
The Prime Minister, who has taken personal charge of implementing the overhaul, will make clear he believes the preparations for the changes are too advanced to be halted and will argue that patients can already see improvements where preparations have been begun.
Andrew Lansley, the Health Secretary, has faced renewed calls to scrap the Health and Social Care Bill from organisations representing doctors and nurses, as well as intense speculation he could be reshuffled out of his job.
Liberal Democrat critics will try to raise the issue in an emergency motion to their spring conference next month and disquiet over the reforms has even surfaced around the Cabinet table.
Last night, Government sources said this afternoon's session was designed to examine in detail how the reforms could be rolled out rather than to discuss amending or abandoning them.
Downing Street said the guest list comprised a "range of national healthcare organisations and clinical commissioning groups", thought to include the NHS Confederation and groups of family doctors who back the shake-up.
However, the British Medical Association, the Royal Colleges representing GPs, nursing and midwives and health unions said they had not been invited to the discussion with Mr Cameron and Mr Lansley. Andy Burnham, the shadow Health Secretary, said: "The NHS means too much to too many people for the Government to play this dangerous game of divide and rule.
"People have strong and sincerely-held views about the risks to the NHS from the Government's re-organisation. They deserve a hearing – not to have the door of Downing Street shut in their faces."
Peter Carter, the chief executive of the Royal College of Nursing, said: "We don't know why we haven't been invited but we, like others, find it extraordinary because at the end of the day, it is nurses, doctors, physios, GPs that actually keep the health service going."
Mr Cameron will today insist patients are already seeing improvements where clinical commissioning groups have been established. He will point to evidence that emergency hospital admissions have fallen year-on-year for the first time as family doctors have been more central in shaping patient care.
Mr Lansley said: "We have always been clear patients will benefit from putting power in the hands of frontline doctors and nurses.
"By starting to do just that, we are seeing a positive change in the way our NHS is responding to rising pressures."