A major expansion of the services offered by GPs was announced by the Health Secretary Patricia Hewitt yesterday, but without any increase in their pay.

Family doctors will be encouraged to set up one-stop shops where they work alongside consultants, offering minor surgery such as cataract and hernia operations and holding outpatient clinics previously available only in hospital.

But Ms Hewitt said the new services, heralded in a White Paper last year, will be funded from cuts in the hospital budget, by help from primary care trusts and individual practices, and would not lead to any rise in the funds paid to GPs.

The British Medical Association responded by demanding more resources.

Family doctors have come under fire in recent weeks after their pay rose to an average of £118,000 in 2005-06, a 63 per cent increase in three years. Ms Hewitt said GPs' profits should be capped after figures showed they had increased by almost £9,000 per doctor on average, cutting the amount invested for patients following the introduction of their new contract in 2004-05. The contract allowed them to opt out of responsibility for weekend and evening care.

Ms Hewitt was speaking at the launch of a report by David Colin-Thome, the Department of Health's national director for primary care, which said services offered by GPs will be "unrecognisable in 10 years". The Health Secretary said: "I am confident that the more we follow this direction the more we will get the convenient and timely care patients are demanding."

She added that a survey of 5 million patients, launched last month, would increase pressure on GPs to provide longer opening hours and better access. For the first time part of GPs' pay, worth up to £8,000 per practice, will be tied to how patients rate them. "As results come through we will immediately see changes in the way GPs work," Ms Hewitt said. "The better their score [on the survey] the more money they will get under their existing contract. If a GP finds their patients are really frustrated [about access] it is a real incentive to change."

Dr Colin-Thome said the changes would not involve more work for GPs, as they could use a shift system to open longer. Hamish Meldrum, chairman of the BMA's GPs committee, said: "Bringing healthcare services closer to home must aim to deliver high-quality local care and not be simply an exercise in cost-cutting."

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