The government has no plans to introduce competition between NHS commissioners, the prime minister's health adviser told the NHS Alliance conference.
But Professor Paul Corrigan admitted that if the world was 'logical' there would be competition between commissioners as well as providers.
The Conservatives are contemplating adopting the idea as policy.
Professor Corrigan said: 'The thing about what we have chosen to do is that we have a population-based way of distributing the money. If you live in an area you are a part of that area. If there is a problem with commissioning in that area it shouldn't be a case where you can choose to opt out of that area.
'If you had a choice of commissioner you would break up some of those relationships and it would not be about levering up the health of the locality. This is a limitation that the NHS is right to impose on itself.' He added that providers would not be able to compete on price 'for the foreseeable future'.
Professor Corrigan said that public health directors had to do more to deal with health inequalities far more quickly.
'The public health profession has been very good at demonstrating what can be done in the medium term,' he said. 'I think all of us have got to work with them on what can be done today.
'We can save lots of lives of 50- and 60-year-olds with specific interventions: that is public health, although it often is not seen as such. How can we help more people today to make more healthy choices in their lives is I think what public health is about.'
He called for commissioners to use data much more to help them understand health needs over the next 20 to 30 years.
'As you understand needs you're going to be looking at creating and commissioning different sorts of services. You'll only achieve that if you recognise you need new forms of provision. Unless there is a market of people looking to do new forms of provision, tying together things that in the past have been separated, we won't have the revolution in care that we need.'