A report by think-tank Civitas said handing GPs commissioning responsibility will lead to at least a one-year dip in performance in the NHS in absolute terms and would set the NHS back at least three years relative to what could be achieved without structural change.

It also outlined that evidence suggesting GPs will be more effective at commissioning than PCTs is 'weak.

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James Gubb, director of the health unit at Civitas, said: ‘Now is not the time for ripping up internal structures yet again on scant evidence base, but for focusing minds on the task ahead and really getting behind the difficult decisions PCTs, as commissioners, will have to make.’

But GPC deputy chairman Dr Richard Vautrey said health secretary Andrew Lansley’s opinion would suggest that a greater involvement of GPs in commissioning will lead to better financial and clinical decisions.

He said:  ‘There is no great evidence of that [poor budget management] during the GP fundholding days. A number of GPs made significant savings, and there is no evidence to suggest that GPs are any worse than current PCT commissioners.’

The coalition government is expected to spell out its aims for GP commissioning to be compulsory in the health White Paper on Monday. Check Healthcare Republic for all the headlines and analysis of what it means for GPs.

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