41% of GPs say the changes will create a postcode lottery, with patients’ experience of NHS services becoming ‘more varied’, according to the survey by GP newspaper in conjunction with the Family Doctor Association.

More than two thirds (71%) of over 300 GPs who took part say the White Paper Liberating the NHS will increase private sector involvement in GP commissioning.

Few GPs believe they will be able to use their commissioning role to build general practice - only 19% say the changes will mean more NHS funding is available to develop practice services.

Some GPs are positive about the changes proposed by the government. One wrote that GPs could ‘make large changes much faster than the current bureaucracy’.

Another said GPs would be good at cutting useless bureaucracy and duplication of effort across NHS services.

But others fear a negative impact. One GP wrote: ‘I think this will be the postcode lottery only more so, there is a complete lack of systems thinking, and all this multiple commissioning with different service agreements will lead to poorer service for patients.’

Another respondent said: 'I think patient experience in the NHS is going to worsen with or without the White Paper changes as money will be cut back whatever happens, however this way the consortia/GPs will be making the cuts.’

Another said: ‘GPs do not have commissioning skills and the more time they spend out of practice gaining these skills the more quality of primary care will be affected. We are excellent at service redesign - that is what we should be doing.’

One GP said simply: ‘A complete and utter shambles - I am glad I am near retirement!’