Patients and doctors have been promised a bigger role in health services as the Government unveiled plans for the biggest NHS shake-up in decades.
GP practices will be obliged to join forces to commission treatment directly under a reform blueprint published by Health Secretary Andrew Lansley.
They will be handed much of the multimillion-pound budget currently handled by primary care trusts (PCTs), which will be abolished along with strategic health authorities.
An independent NHS Commissioning Board will oversee the new regime, with local councils taking over the public health element of PCTs' work.
Under plans set out in a White Paper, the Government also promised to scrap "top-down" targets in favour of a regime based on clinical outcomes.
And patients will be handed more choice over how and where they are treated.
The document warned that NHS job losses were "inevitable" but said it was vital to switch cash from bureaucracy into frontline services.
Mr Lansley said: "The sick must not pay for the debt crisis left by the previous administration. But the NHS is a priority for reform too.
"Investment has not been matched by reform. So we will reform the NHS to use those resources more effectively for the benefit of patients."
