The 48-hour target for patients to be seen by GPs is to be scrapped under new plans being negotiated by the Government.

The 48-hour target for patients to be seen by GPs is to be scrapped under new plans being negotiated by the Government.

GPs will instead be paid for seeing patients on the day they request, rather than forcing them to attend sooner than they wish, whether that is the same day, the next day or in a week's time, John Reid, the Secretary of State for Health, said.

He was responding to criticism of the distorting effect of targets on the NHS after the Prime Minister, Tony Blair, came under fire during a live television debate on Thursday night.

During the BBC Question Time Leaders' Special programme, Diana Church, a member of the audience, complained that it was impossible to book appointments with a GP more than two days in advance since the 48-hour target had been introduced.

A baffled Mr Blair responded: "Surely they [GPs] are not saying you have to have [an appointment] quicker than you want it?' He was assured by a vociferous section of the audience that that was, indeed, the case.

But last night Mr Blair conceded that the Government should set fewer targets for public services.

He told the BBC: "I think that in the health service and in schools, targets are important, but there has been a danger, if I am frank about it, that they have been too crude. What we need to do is to keep them, but make them sufficiently flexible and not to have so many of them that they overburden the system."

The problem in the NHS began when Labour told GPs in 2003 they should see patients who requested urgent appointments in 48 hours and offered payments of about £11,000 a year to those practices that met the target.

Some practices responded by refusing to make advance appointments. The Health Department said yesterday that the latest figures showed these had fallen from 12.4 per cent last November to 1.6 per cent in April.

Mr Reid conceded yesterday that though the percentage of practices was low, the number of patients affected could be high because millions of people consulted their GPs every day.

"In 1997, most people were complaining they couldn't see a GP for a week or more. That situation has been transformed. The vast majority of people now can see a family doctor within 48 hours," he said.

But he acknowledged there were "wrinkles" to be sorted out over advance booking of appointments. "The solution is not to stop patients getting quick access to their family doctor, as the Conservatives and Liberals suggest, but to reward family doctors who see the highest percentage of their patients on the day of the patient's choosing - both for the majority of patients who want to be seen fast and the minority who want the convenience of booking well ahead. And that is what we are discussing incentivising family doctors to do as part of their new contract," he said.

GPs are currently paid £11,000 a year if they see all patients who request an urgent appointment within 48 hours. Under the new plan, payment would be made to GPs who saw at least 80 per cent of their patients on the day they requested.

A Labour spokesman said the 80 per cent figure was a suggestion to be negotiated with the medical profession.

A spokeswoman for the British Medical Association said: "That would be a significant change. We will look at it but it still leaves the decision when to be seen in the patient's hands, whereas doctors want the right to prioritise patients according to clinical need."

The Tory health spokes-man Andrew Lansley said: "Throughout the NHS doctors are being prevented from treating patients according to clinical need because Labour's political targets dictate what they do."

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