Cameron stands by Lansley

David Cameron is standing by his health secretary and his NHS bill

"Kill the bill. Sack the health secretary."

That is the cry coming from a very curious coalition.

Out front are opponents of the government's NHS plans - led by the Labour Party but followed by a growing number of groups representing doctors, nurses and midwives. Behind them, muttering rather than shouting, are some supporters of the very same reforms.

They argue that ministers could have brought about most of the changes they want without new legislation.

They fear that necessary reforms will now be blamed for anything that goes wrong in the health service, even when shortage of money may be the real problem.

They believe that Andrew Lansley's presentation of the changes has been little short of calamitous.

That deep frustration is what was probably behind the colourful remark quoted in The Times this week. An anonymous but exasperated prime ministerial aide was reported to have said: "Andrew Lansley should be taken out and shot".

Yet David Cameron has twice recently passed up the chance to fire his health secretary when first Liam Fox's and then Chris Huhne's resignations forced cabinet changes on him.

And today he backed both the man and his bill.

Why?

In part because some one-time critics - like Shirley Williams - have now been won over.

In part, perhaps, because he will not want to throw a lifeline to Ed Miliband by making a humiliating U-turn.

And in part because some changes have begun and some argue that the law now needs to catch up with them.