I see no reason why staff who do a good job for the public should not be rewarded for what they do

Tony Blair

A lump sum of approximately �5,000 will be paid up-front to help practices provide improved services - such as extra clinics, extended opening hours, training GP specialists and better heart and cancer services.

A further �5,000 will be paid at the end of the year to those practices that have signed up to, and met targets set locally.

GPs can take it as a cash sum for themselves, reward practice staff or put the money back into patient services.

Some �25m is to be made available over three years to establish Teaching Primary Care Trusts - equivalent to teaching hospitals in the acute sector - in areas of special need. Cash will also be made available to help GPs and nurses improve their knowledge of cancer and provide better support for patients and their families.

In addition, the government has drawn up a list of 36 measures designed to reduce bureaucracy in general practice. They include:

• from Spring 2001 GPs will no longer be expected to counter-sign driving licence applications
• GPs do not need to provide jurors with a certificate to excuse them from jury service
• GPs will no longer be expected to counter-sign passport applications from June 2001
• GPs are not required to certify immunisation returns
• the power to certify incapacity for work will be extended to nurse practitioners subject to successful pilots later this year
• the number of medical reports produced by GPs for life insurance companies is being reduced

These are small but welcome first steps

Dr John Chisholm, British Medical Association

Mr Blair said he wants to reward "enterprise and effort" wherever it is found in the public sector. He praised GPs for their hard work, and acknowledged that they worked under "intense" pressure.

He said: "I know teachers, police officers, nurses and other NHS staff did not come into public service primarily to make money.

"They are motivated by a sense of vocation. That's something that is beyond price. The public and the government value that commitment.

"But I see no reason why staff who do a good job for the public should not be rewarded for what they do."

Doctors' leaders have complained that GPs are giving an average of 10,000 consultations a year - 50% more than in 1948 when the NHS was founded.

A joint British Medical Association and RCGP report stated that an extra 10,330 full-time GPs were needed to provide a satisfactory service in the health service in England and Wales - an increase of almost a third.

But the government only plans to appoint an additional 2,000 GPs by 2004.

BMA response

Dr John Chisholm, chairman of the BMA GP Committee, said: "These are small but welcome first steps but there is much more to be done.

"Doctors want to spend more time with their patients. We need to evaluate today's announcements to see how they will help them do that.

"GPs are already working beyond the limits. Asking them to work even longer would be inviting yet more early retirements, burnt out doctors and ultimately a poorer service for patients."

Shadow health secretary Liam Fox said: "How typical of a spin-obsessed Labour party to believe that it can make a few announcements before a general election and all will be well.

"They must think doctors were born yesterday.

"Any report to cut red tape and paperwork for GPs should come with a very long apology to doctors and patients for the huge waste of time that this government's interfering initiatives has already produced."