Doctors leaders warned that in inner-city areas, hardest hit by the shortage, private companies would seize the opportunity to provide a service which would exclude the poorest and most needy people.
Overall, the NHS is "haemorrhaging" doctors, the profession was told on the second day of the British Medical Association's annual meeting in Brighton, east Sussex. The GP crisis is no longer imminent; it has arrived, the association says.
Dr Ian Bogle, chairman of the BMA's GP committee, urged the Government to take immediate action to increase the number of doctors. "We are facing a disaster ... with the potential for the complete breakdown [of the service] in inner cities."
Dr Ian Banks, a GP from Northern Ireland, said that in east London there were 140 vacancies, and a costly recruitment fair had failed to win a single new GP for the area.
Dr George Rae, a member of the BMA council, said that in Sunderland it was "nigh impossible" to get new GPs, while in the Redbridge and Walthamstow area of north-east London, more than half of the 240 GPs were at or approaching retirement and unlikely to be replaced.
Dr Rae said: "It is an irony that we are coming to the age of a primary- care led health service, when there are not enough troops to man it."
Nationally more than 50 per cent of GPs training schemes are under-subscribed, with young doctors from other European Union countries - who will not settle here long term - increasingly taking their places. The number of GPs in training fell by half between 1988 and 1994, the meeting was told.
Disenchantment with life in general practice is due to an ever-increasing workload. Unsocial hours, low morale, and an increase in complaints triggered by the Patients' Charter are also factors. Between 1985 and 1992, the number of GPs working 60 hours or more a week, more than doubled.
Dr Banks said that the level of newly qualified doctors entering GP training was at its lowest ever, while the number of GPs between 60 and 69 dropped by almost a quarter between 1988 and 1994. "Not only is there not enough water going into the bucket, but there is a hole at one end of it as well," he said.
The Government's claims that the number of GP principals have increased by 4.9 per cent did not bear scrutiny, Dr Banks added. The number of full- time GPs actually fell by 700 between 1990-94.
t A stress counselling telephone service set up by the BMA in response to demands from members received 800 calls in its first 10 weeks. Complaints about work-related stress were running at levels about four or five times higher than some other professions. The pilot scheme, which cost pounds 250,000 annually, is to run for a year.Reuse content