Primary care trusts have rounded on the British Medical Association for drawing patients into its pay row. The accusation comes after the doctors' union distributed thousands of posters warning the public that the family doctor service is under threat.
The increasingly acrimonious row took a new turn last week when BMA GPs committee chairman Laurence Buckman wrote to 32,000 GP members updating them on the general medical services contract negotiations.
The Department of Health has given formal notice that it intends to impose a new contract if the BMA and NHS Employers cannot negotiate a package to extend general practice opening hours.
Dr Buckman's letter included an A4 poster for GPs to put up in their surgeries, headlined: "Your general practice and the family doctor service in general is under threat." It said: "The government is taking steps which doctors believe will harm patients. It is encouraging commercial companies to set up and provide GP services, but many doctors are concerned that if this happens, company profits will come before your needs."
The poster does not refer to the row over opening hours, saying only that out-of-hours services have got worse in some areas and this is the fault of government and local primary care organisations.
David Stout, director of the NHS Confederation PCT Network, said: "I am disappointed that the BMA is drawing the public into something which in essence is a pay negotiation between the government and GPs. Using this sort of scare tactic with the public is ill judged."
But a BMA spokeswoman denied it was scaremongering. "The GPs committee is very concerned and GPs are very concerned about the whole direction that the service is going."
Asked if the BMA had gone to war with the government she said: "Yes, very definitely."
Mr Stout said PCTs were watching the negotiations carefully. The operating framework makes PCTs responsible for delivering extended hours in half their practices. Negotiating this locally with an imposed contract would be extremely difficult, he said.
An NHS Employers spokesperson declined to comment because talks with the BMA are ongoing.
A DH spokesperson said: "The government wants to work with GPs to make sure patients can have better access to their doctor. That's why we spent months discussing a package that would both improve access and increase investment in primary care. We were disappointed the BMA did not agree this package but hope that frontline GPs will consider it in detail."
Virgin Group's new business, Virgin Healthcare, is set to join the primary healthcare market this year. The firm will lease premises to NHS GPs and other healthcare professionals, generating additional income by providing ancillary services such as management or therapy services. Virgin Healthcare chief executive Mark Adams said: "The Virgin Healthcare model is to work with healthcare professionals under existing NHS contracts. They will retain their independent contractor status and Virgin Healthcare will seek to expand and offer more patient services in existing practices. Virgin Healthcare does not intend to bid for alternative provider medical services contracts."