Overseas visitors and failed asylum seekers could be forced to pay to see a NHS GP under government plans to crackdown on "health tourists".
Millions of people register with NHS GPs each year
The proposals were outlined in a consultation document published by ministers on Friday.
The move comes just a month after new rules were introduced forcing overseas visitors and failed asylum seekers to pay for treatment in NHS hospitals.
Ministers believe health tourists cost the NHS millions of pounds each year.
The proposals were outlined in a consultation document, published by Health Minister John Hutton on Friday.
It includes proposals to allow GPs to charge overseas visitors before giving them medical care.
It also includes proposals to require patients to prove that they are entitled to free treatment on the NHS.
This could involve producing a passport or NHS card or the proposed new identity card.
At the moment, many practices allow patients to register without seeing their passport or NHS card.
Speaking to the BBC, Mr Hutton said he believed there was a need to take action.
"With over five million new registrations with a family doctor every year, I think there is a danger that NHS resources are being used on people who may not be entitled to them," he said.
"We are trying to get in place a clear set of rules which everyone can
understand and which we can then enforce sensibly and with the least possible
He added: "We just simply have to respond to the concerns that are being expressed to us and we have got to safeguard taxpayers' resources. That's what we are trying to do."
The proposals will aim to bring primary care in line with hospitals. The consultation process will run until 13 August.
Since April, overseas visitors and failed asylum seekers have had to pay in advance for any treatment they have in hospital.
Only those who are admitted as an emergency or have an infectious disease are exempt.
A recent study suggested health tourism costs the NHS up to £200m each year. However, there are no accurate figures.
Shadow Health Secretary Tim Yeo said: "It is unacceptable that scarce NHS resources are being wasted.
"By failing to get a grip on our immigration system, Labour is letting down the NHS.
"The devil will be in the final details but we will not tolerate ministers using GPs as back stop immigration officers."
Liberal Democrat health spokesman Paul Burstow said: "To date the government has failed to produce the evidence that those who are ineligible are massively draining the resources of the NHS.
"The government is in danger of scapegoating some of the most vulnerable people and fuelling prejudice with these proposals."
The British Medical Association said it would consider the proposals carefully.
"We will be studying and responding to the consultation document and the government's proposals for preventing health tourism," said Dr John Chisholm, chairman of its GPs committee.
"Some other services may need to be free for all on public health grounds, for example dealing with specific communicable diseases.
"We also need to consider the impact of these proposals on certain groups such as failed asylum seekers who are still living here and have continuing health problems."
Gill Morgan, NHS Confederation chief executive, said: "It is of paramount importance that people who are in real need can get access to care, and any new system must not be over-complicated for GPs, who are already facing a challenging agenda."