Speaking at last week's NHS Alliance conference, DoH director of system management Bob Ricketts said that WCC was 'getting serious now'.
'PCTs cannot afford to continue with business as usual,' he said.
He added that, from this summer, there will be a commissioning 'failure regime', for tackling PCTs whose commissioning is not up to scratch.
'If PCTs cannot do this they should get out of the way, as we can't afford to get this wrong,' he said.
The move could mean that GPs bidding for APMS tenders or other new contracts could find themselves negotiating with private commissioners.
Government policy is for PCTs to hive off directly-provided services into independent or 'arms length' bodies.
Stripping PCTs of commissioning power too would leave them as skeleton organisations, responsible mainly for managing budget and contracts.
Mr Ricketts declined to comment on who could take over the commissioning role, but said 'there are a range of folk who could do that'.
More details will be clear when the failure regime is published in early summer, he said.
He stressed that the move would not mean a further reorganisation or abolition of PCTs.
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