Haxby and Wiggington Health Centre, a GP surgery just north of York, has helped Yorkshire to make its mark on the latest round of NHS reform.

The practice had sent a letter in the summer to patients on its list who had requested minor operations in recent months.

The letter said these procedures were “no longer paid for by the NHS” – meaning a funding decision had been taken by NHS North Yorkshire and York, rather than the whole service.

It then explained a company owned by the surgery’s GPs offered those procedures, and listed its clinic times and prices, alongside those of alternative private providers. The story was covered in the national press and the practice came in for a lot of criticism, including some from the primary care trust.

The practice insisted its intentions were good (just to get the surgery done) and said it would not have made much money on the operations.

But the Socialist Health Association – which unearthed the letter – and others used it to highlight fears about the exacerbation of conflicts of interest under the government’s GP commissioning reforms.

Many fear GP practices will in future be able to decide which treatments are available on the NHS, reduce them, provide the services themselves instead, and earn direct income, as well as have the freedom to commission or refer to providers they own.

Given the reaction to the story, the Department of Health must be worried. A key test will be its approach to the commissioning groups, which are composed almost entirely of GPs who also share a stake in a provider company.