Dr Sam Everington, famous for the innovative Bromley-By-Bow Health Centre, has written to the PM asking him to withdraw the Health And Social Care Bill on behalf of Tower Hamlets CCG, which Everington leads.

Pulse has obtained a copy of the letter, which can be read here.

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This has the timing and impact of a heavyweight's right hook. It could have a seismic result.

Everington is a relative moderate among the BMA's medical politicians: he has been a deputy-chair, and is currently a member of Council. As the related Pulse story notes, Everington advised Labour on primary care (and was certainly influential on Lord Darzi's plans for polyclinics).

However, Dr Everington was also Health Secretary Andrew Lansley's special guest at the Conservatives' spring conference in 2010., Mr Lansley's speech ''Our NHS - Our Number One Priority' can be read here.

Moreover, the Bromley Centre was Mr Lansley's venue of choice for his first major speech as Health Secretary on 8 June 2010. (Interestingly, its text was altered on 7 December 2010.) We reviewed it at the time, which can be found here.

Everington's letter cannot be dismissed lightly - though Andrew Lansley, or if we are really lucky, #SimonBurns4SOS will have a go at doing so.

This marks a new point on the Richter Scale of reform. The previous high mark in December 2010, when Ealing PCT CE Robert Creighton described the reforms as "at risk of blowing it seriously ... (potentially) a bloody awful train crash. It could collapse" and Comrade Sir David Nicholson did not demur when Dr Sarah Woolaston told him at the health select committee that PCTs were "in meltdown", now looks fairly mild in comparison.

Andrew Lansley will be answering an Urgent Question in the Commons at 3.30 this afternoon on the comical Clegg-Williams letter, which this website analysed yesterday.

Fun, fun, fun.