A last-ditch attempt by GP hardliners to scuttle the government's NHS reforms was overwhelmingly rejected by the British Medical Association's 'annual parliament' this week.
The 600 doctors gathered at the BMA's annual representative meeting threw out a call for 'a ballot of all GP principals to determine whether a majority support the creation of primary care groups'. More than two-thirds of delegates voted against.
The meeting went on to congratulate its GP negotiators on their 'success' in extracting concessions on the control and funding of PCGs from health minister Alan Milburn.
Buckinghamshire GP Jonathan Reggler led the call for a ballot, saying PCGs would make GPs 'rationers of care'.
And Western-super-Mare GP Philip Carman claimed that the GP negotiators led by general medical services committee chair John Chisholm had 'rolled over like puppies and asked to have their tummies rubbed by Mr Milburn'.
But outgoing council chair Sir Alexander Macara told conference: 'It is a great victory won for GPs. There are people out there spitting blood about it, including our colleagues in the Royal College of Nursing. The GPs' own conference supported this: are we really going to snatch defeat from the jaws of victory?'
But the government did not have an easy ride. Doctors warned that the pace of change on PCGs was 'unmanageable and could destabilise the health service'.
And the meeting, which last year voted to support 'the limited exploration of PFI as a means of funding within the NHS', hardened its stance and voted that the private finance initiative should be 'abandoned'.
Questioned by journalists, Sir Alexander denied that he had 'fallen out of love' with the Labour government after its first year in power.
'I have not been in love with the government,' he said. 'Government is there to be criticised.'
In his last speech as council chair, Sir Alexander implored the government to 'face the facts' that new hospitals and doctors were needed, and criticised the 'facile' inclusion in the The New NHS white paper of a denial of a need for rationing.
He called for more NHS funding and unleashed particular criticism of the government's PFI policies.
'We see this government's convincing argument against PFI while in opposition now curiously translated into enthusiastic implementation when in power: an about-turn that would be a comic turn if it were not tragic,' he said.