Practices should be forced to take part in practice-based commissioning and have their contracts terminated if they fail to make savings, a controversial new report suggests.
The report by health think-tank the King's Fund says that under the current rules for commissioning, PCTs have little recourse against 'substandard' commissioning that could deprive other practices of funding.
Dr Richard Lewis, co-author of the report and fellow in health policy at the King's Fund, said commissioning had to be regulated 'through greater power for PCTs in the giving and taking away of contracts'.
Dr Lewis said there had to be a 'hard edge' to the policy to ensure NHS reforms worked.
But Dr Chaand Nagpaul, chair of the GPC commissioning and service development committee, said the suggestion was 'totally misguided'.
He said: 'We've only just managed to raise morale from the verge of a resignation ballot a couple of years ago.'