Accusation: Health Minister Ben Bradshaw says GPs have a 'gentlemen's agreement' not to accept each other's patients

Some family doctors are denying choice by making ' gentlemen's agreements' not to take on each other's patients, a health minister said today.

Ben Bradshaw said they were blocking the Government's patient choice agenda by making it impossible for people to change if they were unhappy with their GP.

He made the allegation on the day he outlined plans to reform the way GPs are paid, saying the current system 'dampened the incentive' to attract new patients.

He said it allowed very small practices to survive and that one surgery  -  which he didn't name  -  in the South of England had only two patients.

It is not the first time doctors have been accused of standing in the way of NHS reform.

Three years ago it emerged that many GPs were refusing to allow patients to book appointments more than two days ahead, against the spirit of Labour's drive to improve access to primary care.

Ministers and the British Medical Association, the doctors' trade union, also clashed recently over extending GP opening hours.

Mr Bradshaw told the BBC that patient choice was under threat because GPs were agreeing with each other not to take each other's patients.

'There's no doubt there are some areas where gentlemen's agreements operate that mitigate against lists being open to new patients and therefore work against real patient choice,' he said.

Since a new contract in 2004, average-GP pay has shot up by 55 per cent to more than £110,000. Only a small amount is related to how many patients are on a GP's books. Mr Bradshaw wants to see this increase.

It would give GPs a financial incentive to treat more patients and encourage competition between them to provide the best services.

GP catchment areas will also be extended, making it even harder for gentlemen's agreements to work.

Last night Laurence Buckman, chairman of the BMA's GP committee, said: 'It is absolute nonsense to suggest there are gentlemen's agreements  -  it just doesn't happen. Nor are we going to compete for patients.'

The new strategy for primary and community care also calls for more email and telephone consultations between GPs and patients and a larger focus on preventing ill health.