More than 50 GPs in new clinical commissioning groups have warned the English NHS may be \"in peril\" if government reforms are derailed. In a letter to the Daily Telegraph, they say opposition to the changes by the British Medical Association is not representative of GPs. Health Secretary Andrew Lansley is proposing the biggest shake-up since the NHS was founded in the 1940s. The Health and Social Care Bill is currently going through Parliament. It would hand power over NHS budgets in England to clinical commissioning groups (CCGs) formed by GPs and would increase competition with the private sector. The existing Primary Care Trusts (PCTs), which manage hospitals, would be abolished. The BMA, the Royal College of Nurses and the Royal College of Midwives have all opposed the proposals, with some critics claiming it is unworkable and \"backdoor privatisation\", forcing Prime Minister David Cameron to \"pause\" the reforms in April last year. But the 56 GPs, part of the NHS Alliance, wrote to the Telegraph claiming previous reforms have not gone far enough and the NHS has \"paid the price\". \'All pull together\' The letter says: \"Without strong clinical leadership and the co-ordinated efforts of local clinicians the NHS itself may be in peril; local services can only be improved if we all pull together.\" \"Blanket opposition to the NHS reforms by the British Medical Association and the Royal College of Nursing is not representative of the views of GPs who, like us, already lead CCGs, and the large numbers of GPs and nurses who support us,\" it adds. The NHS Alliance describes itself as \"an independent non-political organisation proud to be at the forefront of clinically led commissioning\". The health service has been asked to make savings of up to £20bn by 2015. The BMA says government policy is incoherent and major changes are taking place on the ground before the Bill has even been passed. It also says \"unanswered questions remain in many crucial areas such as practical implementation and how individual components within the reforms will work together\".