Senior staff are fleeing the NHS as the coalition government faces mounting opposition to its reforms bill.
Health Secretary Andrew Lansley hopes to pass the Health and Social Care Bill, which proposes the passing of commissioning duties from Primary Care Trusts (PCTs) to GPs.
The bill is fighting huge opposition, with the Labour Party branding it a "disaster", while the British Medical Association, Royal College of Nurses and majority of GPS are calling for it to be dropped.
Sources have revealed serious disorder within the health service, as pre-emptive re-structuring work has taken place in expectation of the bill being passed.
Karen Reissmann, a mental health practitioner and representative of the Bolton branch of Unison, told International Business Times UK that several PCTs had been left "like the Mary Celeste" by senior staff "jumping ship".
"Effectively the NHS has been operated for about the last year under the assumption that the bill has already been passed," she said.
"Changes have been made all over the place and the health service is in a situation now where it would be in real trouble if the bill had to be dropped, because so many of the best staff have left."
No Way Back?
The reforms of the NHS have faced strong opposition from the House of Lords, where parliamentary undersecretary of health Earl Howe admitted that the government had no plan B if the bill ends up being shelved.
"A lot of the restructuring that has gone on has been pushed by staff who are wondering whether they will be keeping their jobs, so they are trying to make themselves as useful as possible by pushing things forward," Reissmann said.
"There is this horrible feeling where people are realising just how much of a disaster this bill will be and they are just trying to protect their position in the fallout.
"One major problem is the fact that the PCTs were not just responsible for commissioning of services, but for a lot of other things, so there is this atmosphere of "OK, well, we can do that" and "we will try and look after that". It's all ad hoc, disorganised and unsustainable.
"There is still a chance that this terrible bill can be stopped. People certainly think it's less inevitable. It seemed that organisations didn't want to clash with a young government so soon after it came to power, but they have realised that something has to be said to stop a disaster."
So far David Cameron has maintained his commitment to the reforms, which many critics believe will open up the NHS to privatisation.
Peter Skolar, a county councillor for Oxford and chairman of Oxfordshire's health scrutiny committee, said there was no way back.
"It has to go ahead now, as PCTs are dying on the vine and, if it is reversed, there is no one left to continue where they left off," he said.
The beleagured bill was hit with another blow on Friday when Tim Montgomerie, editor of the influential Tory website Conservative Home, wrote an editorial calling on Cameron to kill the bill.
"[We] support the Government's radicalism on schools, welfare and the deficit. We'd like to see much more ambition on competitiveness and changing Britain's development with Europe," he wrote.
"The NHS Bill is not just a distraction from all of this but potentially fatal to the Conservative Party's electoral prospects. It must be stopped before it is too late."