GPs and primary care groups have been 'surprised' by 'liberal' guidance on sponsorship deals with drug companies.
Draft guidance on commercial sponsorship from the NHS Executive says 'collaborative partnerships with industry can have a number of benefits' as long as possible conflicts of interest are declared to the public.
Relationships between pharmaceutical companies and the NHS 'if properly managed are of mutual benefit to the organisations concerned'. But all deals, including those already in place, should be reviewed in the light of the new directions, it warns.
Family doctors were often criticised under the previous fundholding scheme for doing deals with drug companies.
Commentators warned that PCGs and PCTs could be open to censure because, for the first time, GPs would be responsible for commissioning most primary, community and hospital care.
The draft guidance, which also applies to trusts and health authorities, has emerged as would-be independent primary care trusts are responding to a set of documents outlining how they should work.
PCTs had to reply to a 'six-pack' of proposed directions on PCT finance, functions delegated from health authorities, management, property, human resources and information technology at the beginning of this week.
Managers, GPs and primary care representatives broadly welcomed the PCT guidance.
But NHS Confederation policy director Nigel Edwards said: 'There is a danger that the guidance fails to make the point strongly enough that these are publicly funded and accountable bodies. It is very important that these organisations don't want to start with different stakeholders jumping to the conclusion that decisions are being stitched up in private and just wheeled out to the public at board meetings.'
The guidance on working with drug companies says they could in some cases pay for nurses and other staff, and for research and staff training as well as offering products at reduced rates.
It warns that in any arrangements with the pharmaceutical industry, 'clinicians' judgement should always be based upon clinical evidence that the product is the best for patients'.
But GPs and primary care organisations were surprised the guidance permitted such a broad range of activity with drug companies.
Mike Sobanja, chief officer of the NHS PCG Alliance, said: 'It is a liberal and fairly open document that says we can do this sort of thing with certain safeguards.'
British Medical Association GP committee negotiator Dr Laurence Buckman said the issue was 'an ethical minefield' in which every player had a different opinion.
Fears that sponsorship could skew doctors' decisions on which drugs to prescribe were matched by fears that without pharmaceutical company funding, research and extra services would be threatened, he said.
But ministers and the NHS Executive should 'stay out of the debate', he added. 'I think ministers advising on ethics is a bad idea. We need a full, public debate to let ethics emerge and a transparent system to ensure that people aren't being bought.'
Clive Parr, chief executive of the National Association of Primary Care, said: 'A few years ago GPs were taken on jollies around the world by drug companies and it was all very suspect, but that has ended.'
The NHS Confederation said trusts and HAs already had to meet the demands of corporate governance which require a declaration of any conflict of interest, and PCTs and PCGs should follow this line.