GPs are enlisting the help of private management consultants to implement the Government's controversial health reforms.
More than two dozen GP consortia have sought advice from McKinsey while NHS managers have enlisted PricewaterhouseCoopers (PwC) to assess when GPs will be ready to take on commissioning services.
The Government's reforms will see around £80 billion of the NHS budget pass into the hands of GPs but many organisations and unions are concerned about the increasing role of the private sector.
McKinsey has been working with GP pathfinder groups piloting the new arrangements.
A spokesman for the firm said: "McKinsey has been supporting more than two dozen consortia from across the UK to build their confidence in taking on new tasks and new roles during their transition to GP commissioning.
"We have worked intensively with individual pathfinders, are running a major national learning network for a dozen leading consortia, and are also supporting a learning network for every pathfinder in one strategic health authority.
"We support consortia in their development with an approach that is tailored, practical, engaged, and expert."
The spokesman said the firm has "tested approaches" that address topics including vision and strategy, delegated budgets, commissioning capabilities, governance, leadership, engagement of stakeholders and patients, and starting up operations.
According to Pulse magazine, which detailed the story, PwC has also been signing contracts with strategic health authorities and primary care trusts to advise on GP consortia.
PwC is designing a national checklist to ensure consortia have suitable governance, management structures and support before budgets are handed over, it said.
Dr Jonathan Steel, a GP in Uley, Gloucestershire, and senior clinical consultant to PwC, told Pulse the firm was advising GPs on leadership, organisational delivery and governance, and was in talks around providing contracting and procurement support.
But Dr Paul Hobday a GP in Maidstone, Kent, told the magazine: "The policy of the moment is 'if it moves, privatise it'.
"All contracts should be transparent, and accounts published in full, as profits come from taxpayers' money."
Karen Jennings, Unison assistant general secretary, said: "Unison has long been warning that the Tories' titanic reorganisation would leave the door wide open for private companies to dominate our NHS - and here is the evidence.
"Just one private company - McKinsey - has already signed up one fifth of the pathfinder consortia, and we know other big companies are getting their teeth stuck into large chunks of the rest.
"They include management consultants and big accountancy firms like KPMG and PwC.
"The health service is about what's best for patients, not the bottom line.
"Less than two years ago McKinsey produced a much-derided report which called for more than 100,000 health workers to be sacked.
"Their vision for the NHS is clear, and was widely panned as being disastrous.
"This is the type of company the Tories are happy to welcome through the front door of our health service."