GPs will be asked to work in the evening and at weekends after the Government indicated that it is to reopen the contentious issue of out-of-hours care by family doctors, The Times has learnt.

Alan Johnson, the Health Secretary, will tell doctors this week that it is ludicrous that surgeries shut their doors as people leave work and that GPs, whose average salary now tops £100,000, must become more flexible and “customer orientated”.

He will ask Sir Ara Darzi, professor of surgery at Imperial College, London, who was appointed a health minister by Gordon Brown in July, to find a solution as part of his review of the future of the NHS.

The Government is hoping to avoid a clash with GPs by using a practising surgeon to conduct the talks with doctors’ leaders. But the chances of an easy resolution appeared slim yesterday, with the British Medical Association (BMA) saying that it would be expensive to overhaul a system that by eight out of ten members of the public found satisfactory. They also said it was unfair on GPs because other professionals, such as accountants, were not expected to work at weekends.

The new GP contract, introduced three years ago, has led to about 90 per cent of family doctors opting out of providing out-of-hours cover, handing responsibility to primary care trusts in return for about a £6,000-a-year drop in pay.

A government source said: “We are not asking GPs to be open all hours or anything unreasonable like that. But we are saying that there is a demand. If they are only open 9-5, then that does not help the people who work 9-5. Perhaps they could open part of the weekend, for instance.”

A survey by the Health and Social Care Information Centre in July found that GPs worked about seven hours fewer per week under their new contract than they did in 1993, despite large overall rises in salaries.

In his first major speech to the New Health Network on Wednesday, Mr Johnson is also expected to acknowledge that Labour has not done enough to tackle health inequalities. He is particularly concerned by figures which show that the gap in mortality between professional and unskilled men has more than doubled since the 1930s.

The Prime Minister has agreed with Mr Johnson that reform of primary care must be at the top of the agenda, and they believe that GPs can do more to promote healthier lifestyles rather than only treating the sick.

Mr Johnson will announce that expectant mothers are to be given a one-off payment of about £120 that they will be encouraged to spend on fresh fruit and vegetables. This is the first time that a payment has been allied to a specific health target. He will also suggest that more doctors are needed in poor areas and greater use must be made of pharmacies, schools and walk-in centres. He also believes that other health workers, such as physio-therapists, must be used more.

Such suggestions will further anger doctors’ leaders, who maintain that people prefer to be treated by GPs and the nurses who work with them.

Laurence Buckman, chairman of the BMA’s GPs committee and a doctor in North London, said that a recent survey showed that at least eight out of ten members of the public were happy with surgeries’ opening hours. “If you open on Saturday morning – and I don’t think there is any wish among GPs to open on Saturday mornings – they would have to shut some other time. Then you are going to be taking care away from the 84 per cent, that includes the elderly, children and the chronically sick, that are happy with it at the moment.” He said that although GPs often ran an emergency service on a Saturday morning they had not run a routine surgery then since the foundation of the NHS in 1948, and this would be extremely expensive.

Alternative suggestions could include dual registration, where patients register at work, or GPs providing walk-in centres at surgeries. Such ideas have been raised with the Government over the past few years but are seen as complex to introduce.

Mr Buckman said that Mr Johnson’s speech, which had not been discussed with the BMA in advance, appeared to be the latest attempt by the Department of Health designed to undermine GPs. “No other professional operates a weekend service. If I have to see my accountant, I have to take a morning off work,” he said.

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