'I think this corpse is not for resuscitation,' Dr David Colin-Thomé told a conference in London last week.

DoH national clinical director of primary care Dr Colin-Thomé insisted the redesign of clinical pathways was still crucial to cutting NHS costs.

But he said: ‘There doesn't seem to be much traction with PCTs. PBC is not taking off in any systematic way.'

NHS Alliance PBC lead Dr David Jenner said it was unusual to hear such remarks from Dr Colin-Thomé.

‘It's the sort of thing he normally tells me off for saying. I don't doubt that it is failing in many areas, but it is still absolutely on the Labour and Conservative manifestos.'

Meanwhile Nigel Edwards, director of policy at the NHS Confederation, said Conservative plans to force GPs to commission services would create opportunities for private companies to do it on their behalf.

Some GPs will not be willing or able to take on commissioning, he said. ‘There will be opportunities for companies like Humana to do this work on their behalf.'

Mr Edwards said questions remained over how Tory plans would work. ‘It will make for intriguing negotiations, and it will require resources.'

Read the full version of this story in this week's GP dated 16 October.