NHS experts have criticised Conservative plans to give GPs responsibility for all commissioning in the NHS as lacking detail.
NHS Confederation chief executive Steve Barnett said: 'At some point it's got to provide that.' At a briefing in Westminster last week he said it was a 'step too far to say GPs have the skills and knowledge to make good commissioning decisions'.
David Furness, leader of the health project at the Social Market Foundation think tank, added: 'Practice-based commissioning hasn't worked. There are only a few GPs that want to, and only a few that are any good.'
He called for PCTs' commissioning role to be strengthened, by making them answerable to patients rather than politicians.
RCGP chairman Professor Steve Field noted that GP training did not currently include commissioning.
In a separate interview, shadow health minister Mark Simmonds stood by the policy. 'Commissioning at PCT level is very patchy,' he said. 'The people who understand the patients best are GPs. Therefore they're in the best place to understand the needs of their communities.'
Dr Michael Dixon, chairman of the NHS Alliance, said interest in commissioning would increase when GPs realised the alternative was other groups, such as private providers, commissioning on their behalf.
The briefing also heard speakers reiterate claims that finding £20 billion of savings by 2014 would force the NHS to close inefficient services.
Professor Field urged clinicians to take a responsible attitude towards service reconfiguration, and accept some services may have to close.
Mr Furness agreed filling the NHS budget hole would require 'difficult decisions', including hospital closures.