Many GPs are privately considering leaving their commissioning roles due to widespread disillusionment and distrust, the Chair of the NHS Alliance has claimed.
In his New Year message to NHS Alliance members, Dr Michael Dixon said current proposals for the National Commissioning Board will not allow CCGs the freedom to create an NHS run from general practice.
Rather, a "command and control environment" will be created and run from Whitehall – ensuring primary care "remains as the junior partner in NHS change".
"Reports of a Commissioning Board with chief professional officers, senior clinical managers and National Clinical Directors are not promising and mention of a primary care clinician as a Deputy Medical Director seems frankly insulting," he said.
He urged the NCB to prioritise the urgent regaining of CCG leader confidence to avoid a commissioning 'Marie Celeste'.
"The majority [of CCG leaders] are enthusiastic, committed, altruistic and talented," said Dr Dixon.
"Yet, there is spreading disillusionment and distrust amongst these leaders and many are privately considering leaving these roles.
"Worse than having no expectations is when expectations are dashed."
A DH spokesperson told MiP the 2012/13 NHS Operating Framework ensures CCGs will have the freedom to make key decisions.
"The NHS Commissioning Board will provide national standards, but CCGs will have the freedom to make decisions about their patients and their organisations from the bottom up. The latest Operating Framework for the NHS emphasises this," said the DH spokesperson.
"By devolving power and responsibility for commissioning services to doctors and nurses on the ground, we are shifting the decision making closer to patients and building on the trusted role that GPs and other front line professionals already play throughout the NHS."
The perceived low management allowance of £25 per head is forcing many CCGs to consider mergers to ensure their commissioning business is viable.
Dr Dixon said this could be "disastrous" as a "PCT mindset" will inevitably be created.
"It does not look like successful local arrangements are being built upon but more like a PCT mindset is being created in hoping to re-create the same number of CCGs as the current number of PCTs," he said.
"Indeed, the current proposed - 261 CCGs - does look remarkably similar to the original number of PCTs."