A clear split in opinion has emerged between the two groups just days before health secretary Andrew Lansley publishes his plans for GP commissioning next week.

The NHS Alliance urges the government not to scrap PCTs and PECs, arguing that they can provide vital support to GP consortia when they are handed up to £80bn a year to commission services.

But NAPC chairman Dr Johnny Marshall said PECs have not been successful and that ‘clinicians within practices and consortia’ should drive the reforms.

The NHS Alliance’s latest report, Providing "Tough Love" - The future for Clinical Leadership at PCT level, argues that PCTs and PECs can help consortia make difficult service reconfigurations and inform patients what is happening with local services.

Dr Marshall said 'Unlike the NHS Alliance, NAPC does not consider that PECs, have, by and large, a success story to tell.'

The DoH has not confirmed reports that PCTs will be scrapped altogether. under the reforms. But acting NHS Confederation chief executive Nigel Edwards believes PCTs could be left responsible for as little as 4% of the NHS budget.

Mr Lansley is expected to make some level of commissioning compulsory for all GPs when he publishes the health White Paper next week.

The GPC says expecting all GPs to become heavily involved in commissioning is unrealistic, but are expecting contractual clauses to ensure GPs monitor their patients' resource use.

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