The main medical unions representing nurses and midwives change their stance on the NHS bill and call for it to be scrapped completely.

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Both the Royal College of Nursing (RCN) and the Royal College of Midwives (RCM) had previously said that opposing the bill in its entirety would cause too much upheaval, and called for their concerns to be addressed within the current proposals.

However the RCN, the biggest nursing union, said "serious concerns" have not been addressed throughout the parliamentary process, and that the health and social care bill will not deliver on its original principles.

A recent change in the bill, to raise the cap on the number of private patients being treated in NHS hospitals to 49 per cent, is a serious threat to the NHS, the RCN said.

The unions change of stance comes as the NHS regulator, Monitor, announced that credit rating agencies - Standard & Poor's and Moody's - will be asked to assess the financial strength of hospitals in case they go bust.

The move follows the decision of the British Medical Association, which represents 130,000 doctors and medical students, to fully oppose the bill.

A spokeswoman for the Department of Health said it was "disappointed" by the royal colleges' position after a year of working with nursing groups over the proposals.

The sheer scale of member concerns, which have been building over recent weeks, has led us to conclude that the consequences of the bill may be entirely different from the principles which were originally set out. Dr Peter Carter, RCN chief executive

Dr Peter Carter, chief executive of the RCN, said that the decision to oppose the bill was not taken lightly.

But he added that changes are already being made on the ground in preparation for the proposed bill, which has not yet been passed, without nurses' and clinicians' concerns being taken into account.

"The RCN has been on record as saying that withdrawing the Bill would create confusion and turmoil; however, on the ground, we believe that the turmoil of proceeding with these reforms is now greater than the turmoil of stopping them," he said.

"The sheer scale of member concerns, which have been building over recent weeks, has led us to conclude that the consequences of the bill may be entirely different from the principles which were originally set out."

The reforms are being proposed at a time when the NHS has been tasked with saving £20bn by 2014, and Dr Carter said: "Patient care is undoubtedly being put in jeopardy."

'Breaking up' the NHS

RCM chief executive Cathy Warwick said that the health and social care bill is a "massively expensive distraction" from the challenges that the NHS faces.

She said that the RCM supported some aspects of the government's proposals, such as clinically led commissioning, but queried the need for a "divisive and costly bill" to achieve them.

"Independent analysts have calculated that implementing the provisions in the bill will cost the NHS an extra £2bn to £3bn on top of the £20bn in efficiency savings the NHS has to find in the next four years," she said.

"Breaking up what we have, embracing the private sector, and injecting full-blown competition and market forces is not what the NHS needs or what health professionals and patients want."

A spokeswoman for the Department of Health said that the bill is needed to empower NHS workers to take charge of improving care.

"Just two weeks ago, the prime minister set out plans welcomed by the RCN to get rid of red tape so that nurses have more time to spend with their patients," she said.

"The RCN has conflated the Health and Social Care Bill with issues about the need for the NHS to spend its money more efficiently."