GP leaders said they were satisfied that the proposals to establish a network of primary care groups (PCGs) were workable, and the major threats to patient care and GP morale had been addressed.

Family doctors are due to vote on whether to take industrial action over the reforms at their annual conference next week, including mass resignation from the NHS and the withdrawal of specific services.

BMA leaders will now advise them against militancy, and instead encourage them to work to make the reforms a success.

However no new money has been promised for the NHS, and GPs still face the prospect of being blamed by the public for lack of resources.

Intensive negotiations

The new package was drawn up following a month of intensive negotiations between ministers and the BMA.

GPs across the country had expressed increasing disquiet with the government reforms, which will see family doctors take control of a single budget for local health services planned in collaboration with other health professionals such as community nurses, and according to guidelines laid down by the local health authority.

Ministers argued the system gives power to the people closest to patients, and scraps the two-tier system that evolved under the Tories, where some fundholding GPs were able to secure fast track treatment for their patients.

Series of concerns

Dr Chisholm: 'The future has been safeguarded.'

But GPs had a series of concerns. Their biggest fear was that, once operations and drugs have been paid for, there would be nothing left to develop family doctors' surgeries.

Now Mr Milburn has given a personal guarantee that the level of investment in primary care infrastructure will be maintained and uplifted for inflation.

The guarantee will mean that money is available for GPs to invest in staff, premises and computers for their surgeries.

He has also given GPs a series of guarantees:

• GPs will have the freedom to prescribe and refer without worrying that money will run out.

• GPs can have a majority on the boards of the PCGs, and a GP can be chairman.

• GPs' independent contractor status will be protected.

• Local medical committees will continue to represent GPs locally.

• Money to run GP out-of-hours services will be protected.

• GPs will be paid for taking on managing responsibilities.

• Incentive payments will be available to innovative GP practices.

No commitment

Mr Milburn said he was unable to make any firm commitment until the Chancellor's review of public spending has been completed.

In a letter to GP leaders, Mr Milburn said: "It is obviously important that we get the details of these changes right.

"Our vision is to create primary care groups that will enable GPs to develop their practices and services, shape hospital and community services and in doing so, improve the health of their patients.

"I can reassure GPs that their future is secure."

Starting gate

GP leader Dr John Chisholm said: "I believe that the progress that has been made gives GPs the reassurances they have been seeking to get them to the starting gate.

"Without such assurances, doctors have been understandably fearful that the government's proposals spelt danger.

"I feel that GPs do now have the opportunity to commit themselves to making 'the New NHS' work, to the advantage of both doctors and patients.