The chairman of the NHS Alliance has called for a "spring clean" of the NHS as the body prepares for its annual conference.
Dr Michael Dixon (pictured) said that the NHS needed to have a handle on the costs of patient care in order to make ends meet.
The organisation said that commissioners have become powerless due to NHS tariffs under the "Payment by Results" system and instead recommended that it be changed into maximum payments rather than a flat fee.
The cost-saving proposal will be included in the paper, Sustaining the Vision, which will focus on how to maintain services during difficult economic times.
Dr Dixon also revealed that demands for increased clinical involvement in NHS management would be discussed at the conference.
He said: "It's time for a complete spring clean of the NHS from top to bottom, with a redrawing of relationships between clinicians and managers."
He added: "GPs need to become local public health physicians. Without that I can't see how the NHS will balance the books."
Policy papers detailing proposals to incorporate primary care with other areas of the NHS and increase patient involvement will be launched at the conference, which is taking place in Manchester on 20 and 21 October.
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"I certainly agree that the wastefulness in the NHS only reflects what is happening in the wider world. Introduction of market forces into the NHS has not worked, and it will not – healthcare provision should not be tied up with private practice – the system enables more fraud to be committed and nothing is done about it. Managers are not all tarred with the same brush, but it beggars belief on what sums of money is being spent in the NHS and yet we have the media on a daily basis reducing staff morale to bits. Who in their right minds would work for an organisation that is staffed by up to 50% foreign workers, some of them who do not even speak English proplerly? Then we have the EU and all their lot entitled to work and get treatment in the NHS but would I get treatment if I went to live in their countries? We should be tackling the medical profession at grass root level – they should not be spending vast amounts of money on treating those who clearly do not want to be well – if you have bad health, it seems you can write out your own cheque as to what amounts can be spent on you to bring you back to good health, only for you to reach for your fag, or the needle – why is the health of the nation so bad?" – Cie Gee, Londinium