The White Paper challenges the government to collaborate with the opposition to introduce legislation this year that would make the core principles set out in the NHS Plan 2000 statutory and establish an independent NHS Board.
Even if the government does not cooperate, legislation would be brought forward in the first session of a new Conservative administration, Mr Lansley said.
NICE would be made a statutory body but the requirement for clinicians to follow its guidance would be shelved.
'Clinicians should have regard to the advice from NICE but must themselves take the responsibility for making decisions,' Mr Lansley said.
He admitted that this will return the country to postcode prescribing.
GPs would be paid fees to offer extended hours in the evenings and at weekends. Fees would make up one income stream for practices on top of a capitation payment and quality payments, simplified and incorporating 'a much greater emphasis on actual outcomes for patients, including patient self-reported outcomes.'
Outcomes, assessed by clinicians and patients, would replace targets.
Mr Lansley denied that increased reliance on performance-related pay would disadvantage poor areas as GPs would be paid according to value-added and improvements.
Practice-based commissioning would be the main commissioning force in primary care, and legislation passed to allow GP practices to hold real budgets, to control contracts with providers and to reinvest savings.
Control over commissioning out-of-hours care would also be removed from PCTs and handed back to GPs, Mr Lansley said.
A new patient voice would be established in the campaigning group Healthwatch.
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