A radical shake-up of the NHS could see doctors being given responsibility for most health services, it has been reported.
The plans, set to be outlined in a government white paper to be published next week, could see primary care trusts scrapped.
Instead, up to £80bn could reportedly be distributed to family doctors and strategic health authorities.
Under the proposed changes, GPs may also take responsibility for 24-hour care and be put in charge of organising out-of-hours services.
The reported changes to the system are in line with the coalition government's belief that GPs understand patients' needs more than most and should be responsible for deciding where money for health services should be spent.
But there are said to be fears within government that family doctors may not have the skills or desire to take on the role. Others have raised questions about accountability.
There are currently some 150 primary care trusts and strategic health authorities, which oversee NHS trusts and supervise local NHS services.
At present, the government allocates funds to local trusts, which then pay for patients in their area to be treated in hospital.
Under the new proposals, doctors would receive the money instead and pay hospitals directly for referrals.
A spokesman for the Department of Health said: "The details of our plans for a patient-centred NHS will be published in a white paper shortly.
"The Health Secretary has highlighted the importance of empowering doctors and nurses in the NHS to deliver quality standards and services.
"The details of how this vision will take effect will be set out soon."
"I think it's very good too many are NOT doing their jobs and helping many of us ill. When you see their salaries and realise. I am fighting a bad disease and have worked in hospitals so know the system" - Lynne Heal, Leicester