Both groups are coy about membership, and both claim it is expanding.

The alliance says it is taking on '100 new members a month' on a base of about 1,000 practices and PCGs. NAPC says figures 'are not available' but Dr Smith admits that membership is down from NAFP levels.

When NAFP transformed into the NAPC last year it claimed 2,000 practices as members.

The alliance's fees have just gone up from£50 for a PCG to£125, with individuals paying£25. NAPC charges£200 for a practice and£100 per 10,000 population for a PCG.