The new head of the National Association of Primary Care has called for GPs to be more accountable for their decisions.
Mike Ramsden said 'GPs should be accountable for the cost effectiveness of the decisions they make' when referring patients to hospitals.
Mr Ramsden, who has worked in the NHS for 26 years intends to up the profile of the association as well as focusing on practice based commissioning and the Darzi review.
He said the NAPC will look to drive forward PBC and 'find ways to make it work effectively across the country'.
'PBC means different things for people in different places. We want to work with primary care trusts and GP consortia to find a way of making it become more of a reality,' he added.
He said PBC was varied across the country as 'some PCTs and strategic health authorities see it more as a priority than others' although he refused to be specific.
Mr Ramsden was Chief Executive of Leeds Health Authority in 1999 until 2002 when he left the NHS to become a director of two companies specialising in consultancy and management services.