A new contract has been published, outlining an overhaul of GP services which will see a 33% rise in funding. BBC News Online hears what patients, doctors and politicians think of the deal.
Spening on primary care is set to rise by 33% by 2006
Mike Stone, chief executive of the Patients Association said overall, he welcomed the new contract.
He said: "Overall, we have to welcome the contract. It provides more money for primary care. And hopefully, it's going to alleviate the loss of GPs from the NHS.
"The important thing is what patients make of this, and how they will see the changes to their GP service come about."
But he said some patients would be alarmed by some parts of it.
"I think people are going to be worried about the changes to out-of-hours cover, especially older people.
"But, at the end of the day, we hope that this contract will still provide out-of-hours cover for those patients who need it."
He said people have to understand they must use the NHS responsibly.
Mr Stone also expressed concern about the proposal that practices would be able to appeal against taking on new patients if they feel they are overwhelmed.
He said: "If you live in a rural area where you have only got one practice, what are you going to do?"
Continuity 'out of the window'
Joyce Robins, of Patient Concer said the new contract would cause anxiety for many
She said: "We have hung on to our current system, tying patients to the list of a
single GP, because GPs have insisted on the importance of continuity of
"Once 24 hour cover is withdrawn, this continuity goes out of the
"Patients will find themselves dealing with locums, who, as a group,
have a poor reputation, phoning NHS Direct or waiting all night in A&E. "
We hope that this contract will still provide out-of-hours cover for those patients who need it
Mike Stone, Patients Association
She welcomed the emphasis on quality in the contract, but said GPs would have to cut down their lists to meet the
"Patients are already finding it impossible to register with any GP when they move house, in anticipation of these changes," she added.
Ms Robins called for a complete change to the system, and pointed to some continental countries where patients can consult any GP of their choice and refer themselves direct to a specialist.
'Jewel in the crown'
Dr Michael Dixon, chairman of GP body the NHS Alliance, said the contract was "a turning point for
He said: "It isn't just about GPs and income, it is about shifting investment
to the front line - where it should have been all along.
"At last we are seeing more than lip service to the principle of a primary care led NHS.
Dr Dixon said some issues still needed to be addressed.
But he added: "For the time being though, this proposed contract offers the best chance in years of restoring general practice as the `jewel in the crown' of the NHS."
He said the NHS Alliance would be encouraging GPs to sign up to the deal.
Martin Roland, director of the National Primary Care Research and Development Centre and a Manchester GP, added: "This new contract has the potential to produce major improvements in health.
"It is a very ambitious plan. No country has done anything like this before and as a result there will be great international interest to see how the contract works."
Dr Evan Harris MP, the Liberal Democrat health spokesman criticised the plan.
He said: "This is the end of the one-stop shop. It means less access to some services, which will now be classed as optional.
"Patients may end up going to one place to see their GP and another for vaccines or baby checks. "
He added: "Patients know that this is a sticking plaster over the fundamental problems of understaffing and lack of access to family doctors.
"The new contract does not solve these underlying problems, it just hides them.
"Patients and their families will rightly feel that the government is still failing to provide the doctors and nurses they need."
Shadow Health Secretary Liam Fox said the contract would need to be examined closely to see exactly how it would affect general practice.
He said: "This contract needs to be seen against the background of morale and recruitment in general practice.
"The increased expectations and huge burden of paperwork and red tape under new labour has taken many GPs to the brink of resignation.
"The devil will be in the detail of this contract, especially in relation to out of hours work and pensions."
He added: "For GPs, as for consultants, the issue will not primarily be about money, but about professional freedom in the face of a government which seems increasing intent on telling them how to do their jobs."