Image caption GPs are taking charge of the majority of the NHS budget under the reforms

The number of GPs who believe that the government's health reforms in England will improve patient care is falling, a BBC poll suggests.

Just 12% agreed that putting GP-led groups in charge of the budget would mean patients saw a "noticeable" improvement.

That figure was 23% when a similar poll was carried out in September 2010.

A majority of the 814 GPs polled also believed there would be more rationing of care because of financial pressures.

In total, 83% said there would be an increase in rationing in their area.

Ministers have cited the financial challenges facing the health service as one of the reasons they have pushed ahead with the changes in the face of mounting opposition.

While 12% of family doctors agreed that GP-led commissioning - the buying and planning of services on a local level - would improve care, some 55% said they disagreed and 33% said they did not know whether or not it would.

The polling also asked about another controversial aspect of the reforms - the role of the private sector.

Asked about the role of private companies in the NHS, 87% agreed the changes set out in the health bill would lead to them having a bigger role.

The King's Fund, a health think tank, said the poll highlighted once again the challenge facing the government in carrying the NHS with it as it implemented the health reforms.

"GPs will be in the vanguard of this - their commitment is essential for implementing clinical commissioning, the government's big idea for ensuring that care meets the needs of patients," said chief executive Chris Ham.

"The public will judge the government's stewardship of the NHS on the basis of whether patient care improves, so ministers should be concerned that many GPs fear that care will get worse rather than better in the years ahead."

Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said the findings came as no surprise and reflected what doctors had been telling them directly.

"Increasingly, GPs are worrying that they will be blamed for making the hard decisions that may need to be made in order to meet the £20bn savings target set by the government. The government needs to be much more upfront with the public about the scale of savings that need to be made and why.

"If those who will have to deliver the latest health reforms are unconvinced and reluctant, the government should take notice of what they say."

April changes

In April next year the control of about £60bn of the NHS budget in England is due to pass to GP-led groups that will plan and buy most routine healthcare for their local community.

Analysis More than anyone else in the NHS, GPs are central to the government's plans for the NHS. If you're a patient in England, your surgery will have agreed to work with others in your area. From April 2013, these GP-led groups - 240 of them - will be taking control of £60bn of the NHS budget. So what GPs think matters, because they're essential to making this new system work. This polling by ComRes suggests a deepening scepticism among GPs that putting them in charge will improve patient care. Some believe they have been given too little power. Others are worried they're taking over as the NHS faces the lowest growth in its budget since the 1950s.

They will be taking over at a time of unprecedented financial pressure. The latest government statistics suggest the NHS is currently managing to meet all waiting targets and has found the savings needed in the last financial year. The polling for the BBC suggests considerable anxiety about what lies ahead.

Almost half of the GPs, 49%, thought the NHS would not be able to go on meeting the 18-week target for routine treatments. Just 22% thought that it would be possible. A similar picture emerged for A&E departments, with 42% agreeing the NHS would need to close or downgrade some in the next five years.

The health secretary Andrew Lansley said the Health and Social Care Act would hand power to GPs, put patients at the heart of the NHS, and reduce needless bureaucracy.

"Of course, every important reform to the NHS, under whatever government, has had its critics from within the system. But putting GPs in leadership positions in the NHS will mean they can improve services for their entire local population. Patients want doctors to make decisions about their care, not managers, and that is what our reforms will deliver."

Andy Burnham, Labour's shadow health secretary, said the findings were significant.

"Most GPs are clear that the NHS is going in the wrong direction and that the government's changes will make it worse not better. These results echo the concerns Labour has consistently raised and flatly contradict the reassurances given by the prime minister to get his Bill through."

The poll interviews were carried out byComResfor the BBC between 21 and 30 March.