Extending NHS competition could undermine any potential benefits arising from the white paper, the British Medical Association has warned.

The BMA’s official response to the government proposals sets out concerns that advantages, such as devolving powers to clinicians, will be “overshadowed” by the increasingly market-based approach to healthcare.

BMA council chairman Hamish Meldrum said: “There are proposals in the white paper that doctors can support and want to work with. But there is also much that would be potentially damaging.

“The BMA has consistently argued that clinicians should have more autonomy to shape services for their patients, but pitting them against each other in a market-based system creates waste, bureaucracy and inefficiency.”

The BMA is particularly concerned about extending the choice of services to “any willing provider”, rather than the NHS being the preferred provider. It also disagrees with the drive for all trusts to gain foundation status, plans to give foundation trusts’ regulator Monitor powers to promote competition and moves to encourage local pay agreements.

In addition, implementing the white paper will require significant funding at a time when the NHS is under pressure to achieve efficiency savings of between £15bn and £20bn 2013-14, the response notes.