Ministers have drawn up contingency plans to emasculate GP fundholding in case the bill to abolish the scheme fails to become law by 31 March next year.
Primary care organisations were tipped off last week that the NHS Modernisation Bill, a key feature of Tuesday's Queen's Speech, might not get through Parliament before primary care groups go live.
A Department of Health spokesperson said that if the bill did not receive royal assent by 31 March, ministers intended to use secondary legislation to, in effect, dismantle fundholding.
'It is sensible planning for the government to make sure that if the bill is not through by a certain date, they can use secondary legislation to bring fundholding to an end,' she said.
The DoH stressed that primary legislation is not needed to create PCGs, which have already been established in shadow form. But primary legislation is needed to create primary care trusts and to abolish the fundholding scheme formally.
The spokesperson said that if the bill had not become law in time, 'a minimal (fundholding) scheme' will remain on the statute until it can be formally abolished, but fundholders 'will not be able to do very much'.
Michael Sobanja, chief officer of the NHS Primary Care Group Alliance, said: 'This government was elected to abolish fundholding and it is very disappointing that they may be unable to do so on their existing timetable.
'It will be unfortunate if fundholders can keep their privileges next year and it is a recipe for arguments at the local level.'
But Clive Parr, general manager of the National Association of Primary Care, said: 'The changes have gone too far. Now we want to make sure PCGs work and work well, and we will support the government in that.'
Opposition parties attacked the plans. Shadow health minister Alan Duncan claimed the government's strategy was 'in disarray'.
Liberal Democrat health spokesman Simon Hughes criticised the government's 'determination to launch PCGs before they have been debated and passed by Parliament', and said the launch date should be put back 'to allow Parliament time to do its job'.
The Queen's Speech included an announcement that the government would 'introduce a bill to replace the internal market, which puts doctors, nurses and hospitals in competition'.
The bill 'will introduce decentralised arrangements with doctors and nurses in the lead in shaping local services'.