The contract promises billions more for general practice

Plans to introduce a new contract for GPs working in the NHS could be put on hold.

Doctors attending a special British Medical Association conference in London have called for key parts of the contract to be renegotiated.

They have also suggested that a ballot on the deal could be put off for six months - a move which could threaten the entire deal.

The nationwide vote of Britain's 36,000 GPs was originally due to take place in March.

It was cancelled at the last minute after it emerged that some GPs could lose money if they signed up to the new contract.

Major blow

The decision to defer the vote further will be seen as a major blow to the BMA and the government.

It comes just seven months after senior hospital doctors rejected similar efforts to change the way they work in the NHS.

We will have discussions with the NHS Confederation and the BMA on the next steps Department of Health spokeswoman

The GP contract was published in February after 18 months of negotiations between the BMA and NHS managers.

It was initially hailed as a good deal for doctors and patients. It promised to transform patient services by increasing spending on primary care by 33% over the next three years.

It also pledged extra money for GPs - an average pay rise of 26% over three years - and a major reduction in their workload.

However, the deal turned sour within weeks after it emerged that some GPs could lose out financially.

BMA negotiators had urged GPs to back the deal. Dr John Chisholm, chairman of its GPs committee, told doctors at Wednesday's conference the contract was the best way forward.

"The contract on offer is better for our patients, the public and the NHS. But it's also better for GPs."

However, he insisted doctors would not be rushed into voting on the new deal.

"I have no intention whatsoever of rushing into a ballot on this contract that result in a 'no' vote," he told the conference.

"GPs need time to assimilate the implications of the full contract."

However, GPs representatives appeared to be dead set against the contract.

They rejected key elements of the package and backed calls for the BMA to return to the negotiating table to secure a better deal.

Birmingham GP Dr Fay Wilson told the conference the contract was full of "disastrous flaws" and doctors should not be "stampeded" into voting for it.

"This product is not good enough. It is not fit for its purpose," she said.

Changes demanded

Doctors demanded that plans to link a large proportion of their pay to the quality of care they provide to patients be watered down.

They also called for a key formula, which calculates how much each practice should receive under the deal, to be scrapped.

The government had warned the BMA against delaying the nationwide vote.

In a letter to negotiators, Health Minister John Hutton said a long delay could threaten the reforms.

"The logistics of the parliamentary processes mean that if the contract does not proceed to ballot shortly, there is considerable risk that the UK deal could not - despite the best will of all sides - be implemented with the timetable set out," he wrote.

The Department of Health said it planned to meet BMA officials to discuss the next steps.

A spokeswoman said: "The GPs committee will be meeting to consider their options and in light of this we will have discussions with the NHS Confederation and the BMA on the next steps."

The Liberal Democrats have criticised the contract saying it will adversely affect patients.

Its health spokesman Dr Evan Harris said: "Even where the new contract is good for GPs, it is bad for patients. It looks as if some GPs will be paid more yet will have to do less."