GPs 'undermining choice in NHS'

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Ben Bradshaw outlined plans to reform how GPs are paid, saying the current system "dampened the incentive" to attract new patients.

But the British Medical Association (BMA) said Mr Bradshaw's claims were "absolute nonsense" while the Liberal Democrats called on him to provide evidence.

At present, GP pay is made up of several components, including something called the minimum practice income guarantee (MPIG). It was agreed by the Government when a new GP contract came into force in 2004 and offers GPs a guaranteed amount of cash every year.

Some 4,500 practices in England receive income protection under this system while others are protected in other ways.

The Government now wants to scrap MPIG, saying it acts as a disincentive and means some practices can continue to run with just a few patients on their lists.

Mr Bradshaw told the BBC: "There is no doubt there are some areas where gentleman's agreements operate that mitigate against lists being open to new patients and therefore work against real patient choice."

But Laurence Buckman, chairman of the BMA's GPs committee, said: "It is absolute nonsense to suggest there are gentleman's agreements - it just doesn't happen. Nor are we going to compete for patients, that is not the way general practice works."

Mr Bradshaw warned the current system was working against Government aims to foster competition and drive up standards in health care. GPs receive an average of £100 for each patient on their list but get only £50 on average for accepting a new patient.

Mr Bradshaw, who has already angered GPs over extended opening hours and polyclinics, spoke as the Government published its strategy for primary and community care. It calls for more email and telephone consultations between GPs and patients and a larger focus on preventing ill health.