Changes to GPs’ working arrangements and a generous pay rise for doctors have cost the Government £1.8 billion more than ministers bargained for, new figures have revealed.

The introduction of performance-related pay in 2004 has led to average GP wages rising by 30 per cent, with some earning up to £250,000 a year.

The cost of the high wage bills and of allowing doctors to stop providing care at evenings and weekends has been blamed for NHS deficits and cost-cutting in recent years.

Between 2003-04 and 2005-06, the Government spent £20.5 billion on GPs – 9.2 per cent more than it promised under the gross investment guarantee when the new contracts were introduced, a report by the NHS Information Centre said yesterday.

This equates to £1.7 billion more than was expected in England, plus overspends of £41 million in Wales and £68 million in Northern Ireland since 2003.

There are no comparable figures available for Scotland.

While doctors now make less in basic pay – about £55,000 on average – for the past three years they have been able to top up their earnings by hitting targets under a performance-related bonus scheme.

The contract also allowed doctors to opt out of providing night and weekend care. About 90 per cent took up the option, leaving it to local Primary Care Trusts to employ private companies, groups of independent doctors and other health staff to provide cover. The changes have been the subject of mounting controversy, with patients struggling to get through to doctors’ out-of-hours and for Saturday surgeries. Meanwhile, the average GP’s total wages have risen to more than £100,000.

Gordon Brown said this week that resolving the lack of out-of-hours care was a priority for the Government, but ministers last night insisted that the extra investment had “improved the range and quality of services” provided by GPs.

The Conservatives said that the figures showed that the Government had crucially underestimated how hard doctors would work under the performance-related pay system.

Andrew Lansley, the Shadow Health Secretary, said: “The extent to which Labour has mismanaged NHS money is shocking.

“An unforgivable lack of understanding of what GPs do on a daily basis has led to £1.7 billion of taxpayers’ money being spent when it could have been saved because this Government badly negotiated the GP contract.

“It’s incredible that ten years after promising to save the NHS, Labour are still out-of-touch with health professionals and the work that they do.”

The British Medical Association, which has opposed any renegotiation of the contract, said that it had repeatedly advised the Department of Health that GPs would peform well under the contract at extra cost.

Laurence Buckman, Cchairman of the British Medical Association’s GPs’ Committee said: “These figures reflect the Government’s wish to invest in general practice by introducing performance-related pay (PRP) for GPs, linking practice resources to the quality of service provided for patients.

“Family doctors rose to the challenge of PRP and delivered higher quality care than the Government anticipated. This is why the gross investment guarantee – a guaranteed minimum spend – was exceeded.

“The figures quoted also include the extra money Primary Care Organisations asked for in order to provide out-of-hours services, as well as a number of other costs that the NHS had to meet that were not due to GPs,” he said.

Ben Bradshaw, the Health Minister, said: “Almost all patients are now seen within 48 hours compared with just half ten years ago and when a patient does need to see a GP they now spend more time with them.

“We remain committed to ensuring that this investment in general practice is matched by further improvements in services for patients,” Bradshaw added. “We are taking steps to tie GP income more closely to patient experience so that further investment leads to greater access and patient choice.”

Doctors have released details of a technique that will allow human eggs to be grown in the laboratory from ovarian tissue samples. The procedure is being pioneered by two British fertility clinics, The Daily Telegraph reports. It would allow women to delay motherhood by “banking” frozen ovary tissue, containing thousands of immature eggs, until they wish to start a family. Hormone chemicals would be used to grow the immature eggs to maturity ready for IVF treatment. The technique is expected to be available for use within five years.

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