Patients who persist in calling out GPs at night for minor problems will be warned that they risk being dropped from their doctor's list. Labour fears that the move will foreshadow charging for night visits by GPs.
Some influential backbench Tory MPs are privately urging Virginia Bottomley to allow charges for night visits as part of the Treasury-led review of expenditure on the NHS. But the Secretary of State for Health is resisting pressure for health charges, insisting that they would break the Tory commitment to the NHS being free at the point of delivery.
Ministers are preparing the advice in a leaflet, under the working title Help Us to Help Yourself, to warn the public against wasteful calls to their doctors. The move is part of the Government's response to growing demands by general practitioners to end their historic commitment to providing 24-hour cover for their patients.
Mrs Bottomley has refused to break the 24-hour commitment, although she is sympathetic to the doctors' complaints. 'She has decided to go for education first, but if that fails, there will have to be some form of penalty,' one ministerial source said.
Surveys have found that some patients treat their GPs like late-night shops. GPs have been called out for 'emergency' treatment, such as the supply of contraceptive pills, which patients should have provided for themselves.
The GPs are strictly limited in the amount of use they may make of deputising services, but the rules may be eased in the agreement reached with the British Medical Association.
Mrs Bottomley will tell the Confederation of British Industry conference this week that there should be more private sector co-operation with the NHS, including investment in sites by some of the big high-street traders.