Prime minister Tony Blair has unveiled a £280m package to improve patient access to the NHS.

The latest move in the government's reform of primary care includes setting up walk-in centres for advice and treatment and extending the NHS Direct telephone advice service.

Mr Blair told delegates at a primary care group conference in Birmingham: 'We need an NHS moulded to the needs of people, not the other way round.'

He said he was making£280m available over the next three years from the government's capital modernisation fund to set up 'fast access centres'.

The money would also be spent on expanding NHS Direct to provide appointment reminders, a single number for out-of-hours services, Internet services, public access points, a healthcare guide and offering training for the public in 'basic healthcare issues'.

The announcement came as the first annual national patient survey showed that 25 per cent of the 60,000 patients who responded had waited more than four days to see their GP.

More than 15 per cent said they had put off seeing their family doctor because surgery hours were inconvenient.

Mr Blair said the NHS needed 'to offer a new option' to people who 'find it difficult to use existing services'.

PCGs will have to bid for a share of£30m to set up the first 20 walk- in centres later this year.

The announcement came despite the finding of the first government-commissioned evaluation of NHS Direct which found that there was no significant evidence that it had reduced the number of patients seeking help from GPs or accident and emergency departments.

The three pilot sites - in Northumbria, Milton Keynes and Preston and Chorley - handled only 33 per cent of the expected 75,000 calls.

Newcastle health authority director of primary care Dr Graham Rich said the plans were 'a major change'. He said they would 'change the gatekeeper role of the GP by introducing another direct access point to the NHS'.

Dr Rich said he would welcome expansion of the Northumbria NHS Direct site, but this would 'require new skills' if centres handling thousands of patient calls were set up. He added that expansion would require 'new money' in the long term, 'after the modernisation fund has expired'.

The British Medical Association's GP committee negotiator, Dr Laurence Buckman, attacked the government's plans as a 'cheap trick to fool the public that the NHS is expanding'.

He added: 'Instead of spending money on primary care we are spending it on shops.'

Kent GP Dr Mark Reynolds, a Department of Health adviser on NHS Direct, said there were 'worries' about the way the service was being implemented without GPs being involved. 'The politicians don't want to listen to criticism,' he said.

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