GPs have warned they may resign from the NHS unless their pay is significantly increased and the government spends more on general practice.

Dr John Chisholm, chairman of the British Medical Association's GPs committee, said doctors would reject a proposed new contract unless it is backed by "substantial rewards".

GPs are currently voting on the framework of a new contract. If the ballot is passed, the BMA will re-enter negotiations with NHS managers to agree the financial terms of the deal which will also be put to a vote of GPs.

The pricing is absolutely crucial to the acceptability of the final contract package

Dr John Chisholm, BMA

Last year, GPs voted overwhelmingly in favour of resigning from the NHS if the government failed to come up with an acceptable contract.

Addressing the BMA's annual conference of GPs in London, Dr Chisholm urged doctors to vote in favour of the framework to enable negotiators to continue their discussions.

Pay claims

He said the proposed changes would reduce their workload and significantly improve their working lives.

But he warned that the government must keep its promise to improve GP pay - currently averaging �62,000 per year.

"The pricing is absolutely crucial to the acceptability of the final contract package. This is the opportunity for the government to demonstrate its stated commitment to general practice.

"If it fails to do so, GPs will reject the contract in the second ballot - not because of greed but because of the consequences for patient care."

Dr Chisholm said GPs also expected pay increases in line with those promised to consultants.

Last week, the government agreed to a 20% pay rise for NHS consultants from 2003.

Dr Chisholm said: "The NHS has to recruit both GPs and consultants. If the salary differentials between ourselves and consultants suddenly increase even further, there will be ineluctable and dire consequences for recruitment to general practice."

The two-day conference will also hear calls for doctors to no longer be required to write sick notes for patients.

GPs believe writing medical certificates takes up too much time and that in the case of school children notes from parents or guardians should be sufficient.

They will also hear speeches from doctors criticising government plans to require GPs to see all patients within 48 hours by 2004.