There is a climate of fear around at the moment

NHS Alliance spokeswoman

Respondents said they were being coerced into merging with their neighbouring PCGs to establish Primary Care Trusts.

PCG members can decide on how best local health services should be run, but they come under the ultimate control of the local health authority.

PCTs have much more autonomy to run local health services as they see fit.

PCGs were only ever seen as an interim measure by the government, which is keen to give NHS workers as much control as possible over health service resources.

A spokeswoman for the NHS Alliance, which represents primary care personnel, said: "There is a climate of fear around at the moment.

"Pressure is being put on people to move faster and faster."

Sister report

The findings of the survey are echoed in a report commissioned by the NHS Alliance from Durham University, which says the government has adopted a high risk strategy by forcing too-rapid change.

Professor David Hunter, one of the authors, said: "They risk alienating the very people they need to make PCTs work."

The government is in danger of pushing the goodwill of primary care professionals too far

Dr Michael Dixon, NHS Alliance

The report warned there was a danger of the reforms "putting form before function" and said the changes should not be rushed.

The investment of time and resources in organisational and leadership development was critical to the success of Primary Care Trusts.

NHS Alliance chairman Dr Michael Dixon said: "Sadly, there is an increasing sense of alienation - especially from doctors and nurses - about a process that is driven entirely from the top with little regard for the views of those who deliver primary care and understand how it works.

"The government is in danger of pushing the goodwill of primary care professionals too far."