Many GPs are retiring early or leaving the NHS

A survey by the Department of Health shows there were 3,435 GP vacancies between April 2002 and March 2003 - up almost a third on the previous year.

It reveals that many of these posts can lie vacant for months or even years.

This is despite government efforts to tackle the problem by offering "golden hellos" worth up to �12,000 to new recruits to general practice.

Extra money

Ministers have pledged to increase the number of GPs working in the NHS by 2,000 by 2004.

They have introduced financial incentives to encourage hospital doctors to enter general practice and to dissuade others from retiring early.

The upwards trend is a matter of great concern Dr John Chisholm, BMA

Earlier this year, they agreed to increase spending on primary care by 33% to �8bn by 2006.

The extra money is being pumped in as part of the new GP contract, which will also see GP salaries rise.

The average GP is expected to earn at least �80,000 a year under the deal, compared to �65,000 now.

Nevertheless, the latest figures suggest that despite all of these new incentives clinics are still struggling to recruit GPs.

Overall, some 3.4% of posts are vacant for at least three months. This compares to 2.7% last year.

The problem is compounded by the fact that fewer doctors now appear to want to work in general practice.

In 2002, there was an average of 4.4 applicants per job. This has now dropped to 3.3.

Two years ago, twice as many doctors were applying for jobs in general practice.

Unsurprisingly perhaps, more than half of doctors say trying to recruit a new GP is harder now than at any point during the last five years.

'Vacant for months'

The survey shows that jobs lie vacant for an average of three and a half months. However, others go unfilled for much longer.

According to the survey, as many as one in three posts are vacant for more than a year. Others remain unfilled for over three years.

There are now more GPs working in the NHS than ever before John Hutton, Health Minister

Clinics in urban areas, particularly those in deprived communities, find it hardest to recruit new doctors.

The survey shows that many jobs become vacant because GPs are retiring early or taking up jobs outside the NHS.

Dr John Chisholm, chairman of the BMA's GPs committee, described the figures as worrying.

"The upwards trend is a matter of great concern," he said.

Dr Roger Chapman, a member of the committee, said the real situation may actually be worse.

"These are declared vacancies. Some practices give up trying to recruit GPs because it is too difficult and these figures are not included," he told BBC News Online.

"This is a very serious situation. If practices are not able to recruit GPs, the remaining doctors must carry out the work.

"That has a big impact and the question is how far that can be pushed before patient safety becomes an issue. That is what we are concerned about."

Health Minister John Hutton said the situation is improving.

"There are now more GPs working in the NHS than ever before," he said.

"We are not complacent. We will continue to take action to ensure there are more GPs delivering high quality services in our communities."

But shadow health secretary Liam Fox said the figures showed "general practice is in massive crisis".

"Never ending ministerial interference and enormous volumes of paperwork resulting from the government's targets has made general practice a less and less attractive career option.

"It is little wonder that more than twice as many GPs were applying for vacant GP posts two years ago than are now," he said.

Liberal Democrat health spokesman Paul Burstow called on ministers to act.

"The crisis is heading towards meltdown," he said.