The report found GPs have benefited from the new NHS contract

The Wales Audit Office said new contracts brought some benefits for patients but had to be managed better to fulfil their potential.

The Welsh Assembly Government said it had noted the recommendations.

But the British Medical Association (BMA) said it was very unhappy with the "inaccurate and misleading" report.

The audit office said the new General Medical Services contract, which formally came into effect in April 2004, had brought some benefits to patients in Wales.

It concluded that, although the contract was helping to improve primary care services, a number of changes needed to be made to the way the contract is run.

Auditor General for Wales Jeremy Colman said the contract has delivered clear improvements for GPs - with better working conditions, a 10% reduction in working hours, and an average 25% increase in GP incomes.

GP incomes have risen by 10% and work hours have dropped 25%

He told BBC Radio Wales: "What we're saying is, the contract has succeeded in making doctors richer - that was intended and we don't criticise that.

"It's promoting benefits in public health, we don't criticise that. But what we're saying is that the contract needs to be tightened up so that those benefits come through.

"They [the government] wanted to pay them more while getting them to do things that would be of long-term benefit to patients - not treating patients just when they are ill - registering patients for particular problems to keep them out of hospital."

He added that the standard needed for GPs to earn points for extra resources needed to continually get tighter "so that bar needs to be raised continually, so that GPs are encouraged to perform better, continually".

'Dreadful slur'

The report entitled Review of the new General Medical Services Contract in Wales, identified a need to monitor more closely the money given out to GP practices.

It also raised concerns about the way improvements were being measured and evaluated by local health boards (LHBs).

Dr David Bailey, Chairman of the BMA's GPs Committee, said the suggestion of the report was a "dreadful slur" on family doctors.

He said: "What they are saying is that because the LHBs aren't doing their job then maybe we're committing fraud. Now that's not acceptable.

"We're completely happy with the whole idea of much more rigorous and much more focused checking, that's fine. We have nothing to hide."

Vacancy rates

The report found general practice was now a more attractive option for young doctors, and that, across Wales, it had led to the oversubscription in trainee schemes and a reduction in vacancy levels.

However, vacancy rates remain higher in Wales (1.8%) than in England (0.7%), and there has actually been an increase in vacancies in north Wales (3.6%).

GP practices now also have more funding for services to offer their patients - leading to an improvement in the baseline activity of practices, and the quality of care for patients in many areas, claims the report.

The report added the level of care had also improved, with the vast majority of patients able to expect to see their GP promptly, and most practices in Wales now demonstrating they were meeting acceptable standards.

In a statement, the Welsh Assembly Government said "Health Minister Edwina Hart had "noted the report and will consider the recommendations".