The government’s pledge to give GPs freedom over buying services for patients could be a hollow promise, according to doctors’ leaders.

The British Medical Association says NHS reforms could instead see health secretary Andrew Lansley and a new NHS Commissioning Board granted powers that are “overly restrictive and controlling”.

But the government hit back at the claims, with health minister Simon Burns describing them as “nonsense”.

The BMA says clauses in the bill go against government pledges to put doctors “in the driving seat” and could prevent them from improving patient care.

The union is concerned that the NHS Commissioning Board, which will oversee commissioning of services, will not be able to operate autonomously and free from political control.

Mr Lansley would also be able to impose “any conditions on consortia without review”, according to the BMA.

The NHS Commissioning Board could dismiss a consortium’s accountable officer and could dissolve a consortia without consultation.

Dr Laurence Buckman, chairman of the BMA’s GPs committee, said: “The NHS Commissioning Board will be given sweeping powers to get involved with the way consortia operate.

“Time and time again in the bill we see no mention of the need to consult consortia on matters that will have a direct and potentially very significant impact on the way they operate.

“And when it comes to the dissolution of a consortium, the most serious act of all, there is no requirement to consult the consortium or the public, and no recourse for appeal.”

Dr Buckman said there were concerns about how restrictive the bill is.

As it stands, Mr Lansley and the commissioning board “are being granted powers that are far too wide-ranging and seem to go against the promise to devolve power to local clinicians”, he said.

Health minister Simon Burns said: “This is nonsense.

“The bill gives GPs power to purchase and design services on behalf of their patients in a way that isn’t possible at present.

“It also restricts, for the first time, the discretion of ministers to interfere in day-to-day decisions in the NHS.

“And it places new legal duties on the secretary of state and the NHS Commissioning Board to promote autonomy and minimise administrative burdens on the NHS.

“Our modernisation plans will give doctors real influence over the shape of NHS services and how they are run.”

Shadow health secretary John Healey said: “Another week, another attack on David Cameron’s high-risk overhaul of the NHS from doctors and health experts. The prime minister and his health secretary talk a good game about giving power to GPs, when the truth is they’re handing the real decision-making powers to an unelected quango and a competition regulator.”