Ministers and civil servants are using 'pressure and dogma' to co-erce primary care groups towards independent trust status, GPs have warned.

PCGs go live in April next year at level one or two, advising health authorities on commissioning care. But in the year 2000 the groups will be able to reach level four, as free-standing trusts.

GP leaders say the message from briefings with senior civil servants is that ministers, keen to prove their flagship policy is working, will 'encourage' health authorities to speed up the process.

Dr Chaand Nagpaul, a member of the BMA's GPs' committee said he did not want to see 'history repeating itself', with Government coercing health authorties as had happend with fundholding.

'The pressure to deliver on the New NHS' was growing and the Goverment was showing signs of pushing PCGs along the four levels of operation.

Dr Nagpaul, who is also a committee member of the NHS Primary Care Alliance group, added: 'We don't have any evidence to show that PCGs will work or that moving up the levels will improve health.'

Health authority managers warned the groups must be left to develop at their own rate.

Newcastle health authority's director of primary care Graham Rich said his areas' five PCGs would be 'moving at different speeds', reflecting the variety of experience among their members 'so the HA has to run five different types of systems.'

Mr Rich said he had not experienced any pressure to move groups towards trust status, but pointed out that: 'representatives of particular interest groups' were 'often more up to date with Government thinking'.

In North Derbyshire 93 per cent of the population was covered by fundholding, the highest rate in the UK. A health authority spokesperson said despite this there was still 'a range of opinion' about developing PCGs: 'One is that it will all be concertined and reach level four very quickly and one that we will never get there.'

A Department of Health spokesperson denied any coercion: 'PCGs go in at level one and they can stay there if they wish.'