Getting rid of the NHS Direct telephone service could be one way of cutting back on health spending, an annual conference of GPs was told.

British Medical Association chairman Dr Laurence Buckman told the meeting of the BMA that the “expensive” phoneline delays getting healthcare to patients.

Other delegates at the London conference highlighted reducing funding for management and new buildings as a way to save up to £20bn in the next four years, although potential cuts to community services will be held up as a concern.

On the NHS Direct telephone service, Dr Buckman said: “It is an interposition between the patient and healthcare. It stops them getting through to nurses and has ended up an expensive telephone service.”

“Unnecessary” tiers of management could also go in a restructuring to save money, Dr Buckman said. He added that new hospital building schemes funded by private money through PFI, walk-in centres and polyclinics should be cancelled.

Responding to the suggestion Nick Chapman, NHS Direct chief executive said:

“The comments Dr Buckman has made about the propensity of NHS Direct to refer patients on, are not backed up by the data on what we actually do. Over half of patients who contact NHS Direct are given self-care advice for their problem, which means they can care for themselves at home without needing to seek face to face appointments. We survey these patients and ask them what they would have done if they had not contacted NHS Direct, and the answer we get is that just under half would have gone to see their GP, and a quarter would have gone to A&E.

“There is evidence that NHS Direct more than pays for itself through the reduction in demand on face to face services. We have conducted analysis with our commissioner (East of England SHA), which shows that in 2008 we saved the NHS £162m by reducing demand on face to face services. This includes £106m through reduced demand on emergency care (A&E and 999), and in the order of £56 million on other primary care providers. This includes 1.7 million GP consultations that were avoided through patients calling NHS Direct.

“It is understandable that GPs are not generally aware of the numbers of patients who don’t go and see them as a result of NHS Direct’s advice. They are, of course, aware of the patients that NHS Direct refers on to their GP because they need to be seen. We refer around 20 per cent of callers on to their GP.“