The NHS must consider charging patients, the British Medical Association has warned in a consultation document being sent to every GP in the country.

Shaping Tomorrow , which is designed to spark a debate on the future of general practice and form the focus of a conference this month, also warns that hanging on to 'the old paternalistic image of Dr Finlay' could 'run the risk of putting GPs in the museum business rather than the business of providing healthcare'.

More than 100 interviewees, including managers, patient representatives, GPs and academics presented their views for the paper. BMA chair Dr Ian Bogle said that, despite howls of protest at the idea of patient fees, 'it is one of the options that has got to be looked at'.

Dr Kenneth Harden, chair of the Scottish BMA GP's committee, said copayment - where patients would pay for some services - was 'potentially dangerous'.

But 'if it is that or a chronically underfunded health service, perhaps we should be prepared to look at it'.

Topics