Pay £20 to see your GP in the evening

Their call is a response to proposals that they should extend their hours to justify salaries which have soared in the past three years.

A group of family doctors from across the country will table the demand at a British Medical Association conference.

Scroll down for more

Doctors on £100,000 will open surgeries out of hours again,,, but only for a £20 fee

The charge would apply only to routine appointments made in advance and not to out-of-hours emergencies, which would still be handled by local primary care trusts.

But the idea provoked fury from patient groups and politicians. Critics say it would undermine the founding principles of the National Health Service - and could put lives at risk if patients delay seeking help.

Michael Summers, of the Patients Association, said: "It is a scandal and wouldn't be tolerated in any other country."

The call for paid consultations comes as GPs head for a showdown with Gordon Brown over surgery hours.

New GP contracts agreed in 2004 saw 90 per cent of family doctors opt out of providing care in the evenings, at weekends and on Bank Holidays in exchange for a small salary cut.

But other elements of the contracts have allowed their pay to jump by almost twothirds, to an average of £106,000.

Out-of-hours callers are now rerouted to NHS Direct, a co-operative of agency doctors or a local hospital.

Increasing numbers off patients are now complaining that they have problems getting an appointment with their own doctor.

This is expected to be reflected in a Government survey of five million patients, due to be published later this month.

Mr Brown, who has promised to make the NHS an 'immediate priority' when he takes over as prime minister, is expected to order GPs to justify their salaries by opening their surgeries in the evenings and at weekends.

But a group of GPs from around the country, concerned that the extra work will not earn them more money, are calling for patients to provide the cash.

At the BMA's local medical committee conference next week they will put forward a motion saying: "Resources for routine care outside core hours should be partially or wholly provided by a fee charged to the patient."

Andrew Green, a GP from Hedon in Yorkshire, said people who wanted evening appointments could afford to pay.

He said: "They are going to be people in employment, almost by definition, and to ask them to bear the extra costs seems reasonable.

"I do not think a fee of £15 to £20 would be exorbitant. This should not be paid for from general taxation."

A related motion, put forward by Nottinghamshire GPs, says that making them attend to patients out of hours would contradicts the Government's obligation to provide a 'familyfriendly workplace for its employees and contractors'.

But Mr Summers, vice-chairman of the Patients Association, said: "The conditions that people suffer from out of hours are just the same as those they suffer from during the day. Why should they have a second-rate service?

"I have been campaigning for some time for the out-of-hours service to be overhauled. People will die otherwise."

Geoff Martin, of the pressure group Health Emergency, said: "This is desperate stuff. Forcing people to pay undermines the whole principle of being able to access primary healthcare as and when you need it.

"It will put more pressure on the ambulance service and accident and emergency departments, because people will pick up the phone or get in their cars."

LibDem spokesman Norman Lamb said: "I suspect a consequence will be people will be accessing A&E more than they do now, which will be completely counterproductive and could place an additional cost burden on the NHS."

The Department of Health insisted last night that payments for evening and weekend appointments would never happen.

A spokesman said: "We will never change the values of the NHS, which is universal, taxfunded, free at the point of need. Let's be clear - nobody should have to pay for these services."

Dr Hamish Meldrum, chairman of the BMA's GPs committee, said the proposal did not echo the views of the association as a whole.

"BMA policy is against patient charging," he said.

The motion comes only two months after the BMA effectively advised GPs to work to rule over the Government's refusal to give them a pay rise this year.

It circulated guidelines telling doctors which services they could cut without breaking their contracts.