NHS chief executive Sir David Nicholson has admitted that the Treasury is concerned abut the government's plans to hand secondary care commissioning to GPs.
Responding to a question at the end of the NHS Confederation's annual conference in Loverpool, Sir David said he was also acutely aware of the need to keep financial control in the NHS as around 500 GP commissioning boards are set up.
However, in contrast to some press reports, he did not indicate that the Treasury's concerns would derail the plans. Instead, he argued that the direction of travel for health policy is clear and that commissioners should start working with GPs to help them prepare for their new role.
"The Treasury is concerned about financial performance and so am I," he said. "I remember 2004-5, when we lost control of the money and had to fight to get that back. I will not put it at risk gain and neither will the Treasury."
The coming reorganisation of the NHS - and the likely demise of promary care trusts as their commissioning roles move to GPs and their provider roles to new organisations - dominated the annual management conference.
Many delegates expressed private concern about their jobs and the future of their staff. However, Sir David urged them to show leadership and to look for opportunities to improve patient care in the changes.
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