But the survey, in partnership with the Family Doctor Association (FDA), found that 47 per cent of respondents remain unsure if the DoH's commissioning plans are an opportunity or a threat for the profession.

Many of the 315 GPs surveyed are concerned that the additional workload will not be adequately resourced.

One respondent, a GP in Swindon, Wiltshire, complained his practice income was being 'eroded to pre-nGMS levels'.

'Commissioning work is over and above GP work, and should be remunerated separately, as was the case with primary care groups,' he wrote.

GPC member Dr Nigel Watson said the committee would resist attempts to fund quality premiums from existing resources. He agreed income must not fall further, but warned the profession should not look to profit from GP commissioning.

'It is unlikely the government will put huge amounts of extra profit into practices,' he said.

'We need to be careful not to increase our income as a result of taking part in commissioning. It would be damaging to the profession.'

Under a fifth (17 per cent) of respondents are confident that commissioning will lead to a better patient experience in the NHS, with many more (41 per cent) concerned that quality of care will become more varied.

More than half (55 per cent) fear the reforms jeopardise GPs' autonomy and independent contractor status.

But FDA chairman Dr Peter Swinyard said he was optimistic that the DoH was in 'listening mode' and would allow GPs to shape the reforms. 'The detail is not yet set in stone. We will end up with a compromise, but it will be a good one,' he said.

The GPC dismissed calls to ballot the profession, saying the move to GP-led commissioning is inevitable.

More than two-thirds (67 per cent) of respondents wanted the GPC to hold a ballot to decide whether to embrace or oppose the reforms.

GPC deputy chairman Dr Richard Vautrey said the profession could be asked for its opinion if there were significant changes to the contract.

• Click here for more details from the GP survey