GPs have given the government a vote of no confidence over its handling of the NHS at their annual conference.
GPs are gathering in London
Delegates at the British Medical Association's meeting attacked a raft of health policies, accusing government of wasting millions of pounds.
Family doctors also branded out-of-hours care "shambolic".
And they said they had been made a "scapegoat" for the problems in the NHS after seeing their pay rise in recent years.
GPs have come under fire for opting out of weekend and evening care following the introduction of a new contract in 2004.
The deal also saw their pay rise by one-third in the space of 12 months, taking average annual earnings through the £100,000 barrier.
Dr Hamish Meldrum, chairman of the BMA's GPs committee, said: "I make no apologies for the pay increases that we have successfully negotiated and no apologies that we are among the best paid in Europeż as we provide the best care."
He also said ministers risk missing their flagship 18-week waiting target next year because cuts were forcing care to be rationed and choose and book, an IT network to link up hospitals and GPs, was not working.
Other doctors at the two-day conference were also critical of the government, culminating in an overwhelming majority of delegates giving both the government and Health Secretary Patricia Hewitt a vote of no confidence.
Dr Eric Rose, a GP from Milton Keynes, said: "Ten years ago when Labour came to power I had great hopes.
"After all, this was the party that created the NHS and whose party election slogan was '24 hours to save the NHS'."
But he said a range of policies, including NHS Direct, walk-in centres, patient choice and use of the private sector, were failing.
"This government is damaging the fabric of the NHS. It has squandered millions of pounds of tax-payers money."
But Dr Michael Griffiths, from Gwent in Wales, defended the government.
"It has not been that bad. Much of the money taken out of the NHS by the Tories has been put back in."
GPs have also passed a motion that says GP out-of-hours arrangements are "shambolic" as patients are not able to get access to experienced doctors.
Stockport GP Dr David Gilbert said: "Some providers are more concerned with profit, flying doctors in from Eastern Europe."
Dr Kevin McBride, a GP from Wiltshire, agreed services were poor.
But he said some of the blame lay with family doctors as most of them had voted to opt out of responsibility for night and weekend care three years ago.
He said they perhaps should have kept responsibility for service and taken on extra staff to cover out-of-hours.
"If we had the vote again, I hope we would be more careful."
David Colin-Thome, the government's primary care tsar, said NHS managers were trying to make the system more efficient.
He added: "We have invested record amounts in out-of-hours services.
"Patients say that they are benefiting from improvements to out-of-hours care..
"I am surprised that the BMA continues to criticise a system that they were involved in negotiating."