The first ten hospitals to be given controversial foundation status have been named.
Control over services will increase
A further two hospitals have asked for more time to work on their applications.
Bill Moyes, chairman of the independent regulator for foundation trusts, said the status was a "great opportunity" for the hospitals.
Opponents of the plans claim they will create a two-tier NHS with non-foundation hospitals losing out.
The ten hospitals, which take on the new title on 1 April, will have more control over their budgets and services though they will remain in the NHS.
They will be able to keep the proceeds of sales of land and premises and will be able to borrow some extra money from financial markets.
The two that asked for more time are North Tees and Hartlepool Hospitals and Rotherham General Hospitals.
Hospitals given foundation status
Basildon and Thurrock General Hospitals
Countess of Chester Hospital
Doncaster and Bassetlaw Hospitals
Homerton University Hospital
Moorfields Eye Hospital
Peterborough and Stamford Hospitals
Royal Devon and Exeter
The Royal Marsden
Stockport NHS Trust
Only hospital trusts with three stars can apply for the change in status. A further 13 are aiming to become foundations from 21 July.
Mr Moyes said: "Foundation trusts will still be expected to deliver against the key national targets - reducing waiting times and constantly improving clinical outcomes.
"But they will now have the freedom, working with their members and the local health community, to identify local priorities and to decide how best to meet
them. It's a great opportunity."
Health secretary John Reid added: "It is a major step on the road to decentralisation and freeing up the NHS from day to day Whitehall control."
The 10 new foundation trusts treat around 2.6 million patients a year, employ 30,000 staff and have a turnover of £1.3 billion.
Their plans include creating a special unit for stroke patients at the Countess of Chester hospital, and an International Children's Eye Centre at Moorfields by 2006.
The Royal Marsden plans to replace its radiotherapy equipment to reduce waiting times and Bradford wants to establish a separate elective orthopaedic unit.
The foundation hospitals policy only scraped through the House of Commons last year as it is opposed by many within the Labour Party.
Peter Herring, chief executive at the Countess of Chester Hospital, said foundation status would give local people more say in the running of services and would give the hospital access to greater funds.
He added: "This is not about creating a two-tier service. It is not to the disadvantage of any of our neighbouring hospitals."
Alan Whittle, chief executive at Basildon and Thurrock Hospitals, said: "This means that local people will be the first to have a say in how their local hospitals are run.
"Foundation status gives new freedoms to make local choices which is good news for everyone - patients, local people and staff."
Rotherham General Hospitals said it needed more time to resolve financial issues. It needed to be sure it would continue to hit all its targets, including financial ones, under foundation status.
Tory shadow health secretary Andrew Lansley said all hospitals should have greater financial freedoms. This would include allowing trusts to keep financial surpluses and letting them retain proceeds from the sale of surplus land and assets.
Paul Burstow MP, Liberal Democrat health spokesman, said the plans were "sham decentralisation". He said: "Foundation hospitals do not give a voice to local people to control their NHS."
Karen Jennings, head of health for the UNISON union, said: "We continue to have severe reservations about the creation of foundation trusts.
"They will have major financial advantages over their neighbours and will also act as magnets poaching essential staff from nearby hospitals."
The Royal College of Nursing said it would monitor the trusts closely to ensure they did not create division in the NHS. But the Royal College of Midwives said they would provide opportunities for midwives to be involved in hospital management.