Clinical commissioning groups will struggle to challenge large “big beast” hospital providers to reshape services, former health minister Lord Darzi has said.

Lord Darzi, who was a minister under Gordon Brown and continues to advise the current government on health, addressed a conference held by the think tank Reform on Tuesday.

He said successive generations of NHS commissioners had been weak partly because of repeated reorganisations.

Lord Darzi said they had repeatedly changed “the anatomy of the NHS rather than its physiology”. He said it damaged the service’s ability to take up and spread innovation.

He said CCGs, like primary care trusts, would not have the maturity to challenge “the big beasts” such as Imperial College Healthcare Trust, where he is a surgeon and chair of the Institute of Global Health Innovation.

Lord Darzi asked: “[in the NHS] We have individual innovators but how do you create a system that will facilitate or encourage the adoption or diffusion of that innovation?”

“The payers [have been] called PCGs [primary care groups], PCTs and now CCGs. They keep changing their names but they have never really had the maturity to actually challenge…a big gorilla or a big beast.”

He said disruptive innovation from the independent sector would damage incumbent providers, which was a “a challenge in the NHS”, and CCGs would be likely to avoid.

He said: “Honest I do not think even the CCGs will be able to do that. Ultimately the CCGs are going to look at it and say, ‘This is our local hospital.’”

Lord Darzi said CCGs would have to consider “are we going to close this thing?”, and: “Are we going to bring in someone from the independent sector or someone who runs a hospital in India?”

He said: “That is going to be politically very, very challenging.”  

Lord Darzi told the conference the NHS was not good at allowing new providers, which would be detrimental to innovation.

He publicly backed the government’s Health Act during its passage through Parliament because, he said, uncertainty created by its delay was damaging to the NHS.