The head of the British Medical Association has launched a withering attack on the government over its handling of the NHS.

In a speech to the BMA's annual conference, Dr Ian Bogle warned Prime Minister Tony Blair that time was running out to solve the problems of the NHS.

He said doctors were close to breaking point.

We have become scapegoats for the failings of a system and a society with grossly unrealistic expectations

Dr Ian Bogle

And he said many would soon have to ask themselves if they were prepared to go on "soaking up the pressure, filling gaps where there are doctor shortages and racing through four-minute consultations wondering afterwards whether we missed something".

Dr Bogle, formerly a GP in Liverpool, said he suspected many would decide the risks, for themselves and their patients were "just too great".

Dr Ian Bogle sounded a grim warning

And Dr Bogle said the optimism engendered by Labour's 1997 election victory had turned to "despair and disenchantment".

He added that morale amongst doctors had been driven to "distressingly new depths" after "malicious attacks" on the profession.

And echoing Tony Blair's famous 1997 election song 'Things can only get better', Dr Bogle said: "Four years on, things can't get much worse."

Dr Bogle warned the government must deliver a better health service in the next 12 months.

And he said the NHS Plan, published last year, setting out long term modernisation plans for the NHS, was not deliverable without a significant increase in workforce and resources.

'Whipping boys'

He told the 600 doctors gathered in Bournemouth that their profession was "under siege" from politicians and the press.

He said: "We have become scapegoats for the failings of a system and a society with grossly unrealistic expectations, whipping boys when government can't live up to manifesto pledges, victims of a complaints culture fuelled by the hysteria surrounding medical mistakes."

He attacked Health Secretary Alan Milburn's reaction to the organ retention scandal at Liverpool's Alder Hey Children's Hospital as "shockingly hysterical" and "unforgivable".

Shortage of doctors

He added that confidence in the GMC, the regulatory body for the profession, had been shaken over the last year.

At the BMA's annual conference a year ago, doctors passed a vote of no confidence in the council.

Dr Bogle said action was needed to attract and keep doctors in the NHS, highlighting a 40% rise in consultant vacancies, and the fact a ballot last month showed more than half of GPs are considering resigning from the NHS.

He said a 30 to 50% increase in the number of consultants was needed, as well as 10,000 extra GPs in England.

Dr Bogle also warned medical school applications were down and medical academic vacancies up.

Other doctors echoed Dr Bogle's disatisfaction with government policy.

Dr Eric Rose, a GP from Buckinghamshire, said the NHS Plan was undeliverable without extra resources.

He said: "It's not a national plan, its more like a national jigsaw puzzle, where most of the pieces are missing. Those pieces are doctors, nursing and other staff."

And Dr Laurence Buckman, a senior GP negotiator, described the plan to guarantee all patients an appointment with a family doctor as "lunatic".

Government response

Later, the Prime Minister's official spokesman said the gvernment was "in a dialogue" with the BMA over the terms of a new contract.

He added: "What we are clear about is that we need to increase medical manpower ... that will obviously relieve the medical workload, but it will take time.

"There are also issues in relation to devolving more power to the frontline, in giving doctors more say over NHS budgets."

He continued: "We do recognise that the medical profession have concerns. We are committed to working with them, to having a partnership which puts the patient first. There will obviously be things that they disagree with us on, and there will obviously be difficult issues that we have to address together.

"We believe that the health plan does give us a framework which enables us to move forward and build an NHS which is more centred on the needs of the patient, and which devolves more power to the frontline."

Dr Bogle's comments met with a lukewarm response from the Royal Collge of Physicians.

The college issued a statement which said: "We were saddened by the very negative nature of his comments. Whilst agreeing with many of Dr Bogle's statements, particularly regarding workload, we feel that improvements are occurring and that substantial investment is being made."

College president Professor Sir George Alberti said: "There is a long way to go to have an NHS in which we can be proud, but now is the time to work constructively with, rather than denigrate, the government."