NHS fraud has been cut significantly

Under the proposals, counter fraud specialists would have greater access to documents and information held by NHS organisations.

Refusal to allow access to papers could result in a nine-month prison sentence, or a �5,000 fine.

Doctors leaders are concerned the plans may damage patient confidentiality, and the trust that doctors enjoy from their patients.

Every single penny of the money we are investing in the NHS must be used for the purposes for which it was intended. Lord Warner

The plans, unveiled by the Department of Health on Thursday, will be put out for a 12-week consultation.

It is still to be decided whether some documents - including patients' medical records - should be exempt from the proposed new powers.

The Department of Health argues the plans will reduce the need for the NHS Counter Fraud and Security Management Service (CFSMS) to use police assistance to search premises or take property.

However, fraud investigators would not have powers of entry, search or seizure.

Health Minister Lord Warner said the government would not tolerate corruption and fraud in the NHS.

The CFSMS has cut patient fraud by 49% in the UK since it was set up five years ago - from �171m in 1998 to �87m last year.

Lord Warner said: "Every single penny of the money we are investing in the NHS must be used for the purposes for which it was intended - new hospitals, doctors, nurses and life-saving equipment.

"The draft proposals published today will strengthen the powers of NHS counter fraud specialists to root out fraud wherever and whenever they find it and help make sure that those who are guilty of diverting valuable resources away from patients face the toughest possible sanctions."

Sensitive investigations

We have to be very careful about providing access to personal information, which could threaten the relationship of trust between doctors and their patients. British Medical Association

Jim Gee, chief executive of the CFSMS, said: "We believe that properly trained specialists, with appropriate powers and who are knowledgeable about the working of the NHS should be able to carry out investigations in a way that is sensitive to the needs of the overwhelming honest majority of patients and NHS professionals.

"We particularly welcome the proposal that the specialists would have powers, not of entry, but of reasonable access, and we can therefore work with the NHS professional to identify a convenient time at which visits can be made to avoid disruption of NHS care."

A spokesman for the British Medical Association said: "The BMA would wish to co-operate with any fair and reasonable measures to tackle fraud in the NHS.

"However, doctors also have a duty to protect patient confidentiality.

"We have to be very careful about providing access to personal information, which could threaten the relationship of trust between doctors and their patients."