The 'whole concept of catchment areas' in the NHS should be abolished, according to the report by the Institute of Economic Affairs (IEA), a Thatcherite think-tank.
'Patients should be able to register directly with any CCG they see fit, and choose freely among primary care providers,' the report says.
The calls hark back to proposals early in the rollout of Andrew Lansley's NHS reforms that CCGs could be allowed to recruit GP practices from outside their geographical area, and to compete for patients.
GPC deputy chairman Dr Richard Vautrey dismissed the proposals as 'nonsense'.
The IEA report says: 'Patients should be allowed to register directly with any CCG they see fit, regardless of place of residence. Meanwhile, CCGs should be free to develop their own profiles and specialities, and build up brand recognition.
NHS internal market
'They should also be free to merge and de-merge as they see fit, especially with other CCGs, and at a later stage, with provider organisations as well. This would lead to the development of an "internal market" on the commissioning side. CCGs would begin to compete for patients, and their "optimal" size and scope would be discovered through a competitive process as opposed to political 29 or bureaucratic fiat.'
Dr Vautrey said that the out-of-area registration scheme introduced recently meant patients could already sign up with GPs where they wanted to.
'The vast majority of patients don’t want to do that,' he added. 'People want a service close to home, when you are sick you want to travel the least distance possible.'
Allowing CCGs to operate outside geographical areas would not work, he argued. 'The idea of CCGs taking over a different bit of the country is nonsense – they are responsible for ensuring care for the population in their area, and as part of that they need a relationship with the providers in their area.
'The idea that a CCG in Chester could start to take over Colchester is nonsense. You would not have same guarantees of quality.'