By Melissa Jackson BBC News Online health staff

There is a shortage of NHS GPs

BBC News Online examines why some patients appear happy to pay rather than use the NHS.

Maeve Craven is one of the many people who now choose to pay to see a doctor rather than rely on the NHS.

The mother of two from Battersea, south London, says she prefers the peace of mind she gets from going private.

"It's so much easier when you have two children and the alternative is to sit in the doctor's waiting room.

"They arrive usually within an hour and a half, which is great when you have a screaming child.

"I think it is worth the money, for the peace of mind. It's cheaper than having private medical insurance.

"I don't have to think about whether it's an emergency or not and whether I should take the children to A&E. I can call a doctor straight away, day or night."

Lots of doctors are unhappy with the level of service they can provide in the NHS Andrew Rae-McCance, 0800Doctor

Maeve has signed up with 0800Doctor, a firm of private GPs.

The company has been delivering private GP care in the capital for over 10 years under the name Doctors Direct.

Andrew Rae-McCance, chief executive of 0800Doctor, says the company is meeting a growing demand from patients.

It recently expanded to cover the whole country.

Mr Rae-McCance said: "Lots of doctors are unhappy with the level of service they can provide in the NHS.

"We are not creating two-tiers, we are freeing up services to those most vulnerable in society."

Doctors abandon NHS

However the service comes at a price. Consultations cost between �60 and �95.

But people are paying and 0800 Doctor is not the only organisation cashing in.

Essex-based U-first Primary Healthcare has seen a growth in the number of patients using its private GP service.

The company's doctors have seen 4,700 patients since its inception in August 2002 - almost half of whom sought private treatment within the last five months.

Because there is such a shortage of GPs, there is always going to be a demand for the private sector BMA spokesman

Most of its doctors are NHS GPs who supplement their income with private practice.

However, more recently, the company has been approached by a handful of disaffected GPs who want to opt out of the NHS completely.

They have refused to sign the newly introduced GP contracts, designed to make the job more attractive and improve their working lives.

U-first Primary Healthcare operations manager Isis Reed said: "Doctors are phoning daily to offer their services.

"Of the doctors who have refused to sign their new contracts, some of them are working for us already and now want to work full time and others are approaching us for the first time."

The British Medical Association says a shortage of GPs is encouraging people to go private.

Continuity of care

"Because there is such a shortage of GPs, there is always going to be a demand for the private sector," says a spokesman.

"Rather than having more private provision of services, the long term solution is more NHS GPs."

The government pledged almost four years ago to recruit an extra 2,000 GPs by the end of 2004.

Private practice in primary care has always been a minority activity and I don't expect that to change Dr Richard Lewis, The King's Fund

Department of Health figures show that just 1,535 have been recruited since 1999. The BMA says an extra 10,000 GPs are needed.

The BMA warns that patients who go private should also tell their NHS doctor.

"If patients are switching between an NHS doctor and a private one, it is important that they each know what type of care a patient is receiving," says a spokesman.

Health think tank, The King's Fund, said it was not surprised to learn that a handful of GPs were planning to abandon the NHS in the wake of the new contracts.

NHS improvements

Dr Richard Lewis said: "None of us knows whether this is just a trickle or something bigger than just a few disgruntled colleagues.

"Private practice in primary care has always been a minority activity and I don't expect that to change."

He suggested the NHS was becoming more flexible and responsive to our health needs, making it a more, rather than less, attractive prospect.

Patients should see a doctor within 48 hours

"My guess is that as NHS waiting lists drop and access to treatment and services broadens, the private care option will become less attractive."

The expansion of 0800Doctor follows the recent opening of Britain's first private casualty clinic in west London in October.

Casualty Plus, which charges patients an initial fee of �29, also has plans to open up in other parts of the UK.

The government is spending billions of pounds trying to modernise the NHS.

Ministers have introduced a number of policies aimed at keeping people like Maeve Craven in the NHS, such as the target to encourage GPs to see patients within 48 hours.

They have also set up the national telephone helpline, NHS Direct, and walk-in-centres to try to compete with the private sector.

Other plans under consideration include giving GPs extra money to open their surgeries in the evenings and at weekends and allowing patients to register at practices where they work for the first time.