Speaking at the annual National Association of Primary Care (NAPC) conference in Birmingham on Tuesday Mr O'Brien broadly welcomed the group's manifesto.
It says that PBC success has been limited and that urgent action is needed.
The 14-page document suggests local practices should form community health collaboratives (CHCs), which would be given real budgets.
The patient voice would be heard in the design of services and also how the health dividend, or freed-up resources, is spent.
PCTs would set headline commissioning outcomes for a population and agree contracts with CHCs.
Once practices have delivered the appropriate quality of primary care services they would qualify to become ‘foundation practices'.
Management resources would transfer from PCTs to develop CHCs.
Mr O'Brien said: ‘Foundation practices would have much greater independence to run budgets. I welcome these ideas. I think the NAPC is bringing forward interesting proposals. The government wants to look at this with great care.'
In a speech that was far more party political than his address to the RCGP conference in Glasgow earlier this month, Mr O'Brien sought to outline the differences between Labour and Conservative party policy on the NHS.
Mr O'Brien explained that smaller practices would not be forced into CHCs or to become foundation practices.
He said: ‘Some smaller practices could be broken if forced to manage budgets. Practices would have the choice rather than forcing them as some would do.'
Once again the theme of Mr O'Brien's speech was that improved quality would result in savings, so important as the NHS has identified that £20 billion must be found to maintain services between 2011 and 2014.