Two charities are planning to launch a campaign to push for GPs' incentive payments to be based much more on their success in improving public health.
The National Obesity Forum and FPA, formerly the Family Planning Association, will lobby for the quality and outcomes framework to include more points related to tackling obesity and providing contraceptive services.
Out of the 1,000 QOF points, which are negotiated between NHS Employers and the British Medical Association, only eight relate to obesity and just two to contraception.
FPA chief executive Anne Weyman told a Unison fringe session at the Conservative conference that the points were based on whether the practice had policies on the provision of emergency contraception and on preconception care, such as nutrition advice.
'We feel that the contract was a real lost opportunity,' she said. 'A public health campaign could help us to get better points in the QOF.'
She said she hoped other charities unhappy at being under-represented in the QOF would join up.
National Obesity Forum clinical director Dr David Haslam said none of the eight QOF points on obesity included childhood obesity - supposedly a government priority.
The points are awarded if the practice creates a register of obese people, but this was 'neither use nor ornament', he said. 'All it does is increase the workload and increase the money that is paid to us.'
He added: 'If we get more obesity points in the contract it will be managed extremely well. It will help us tackle health inequalities because it will be in the doctor's interest to put as many people on the register as he can. He'll go looking for disadvantaged people or those from minorities to get on the list.'
He poured scorn on health secretary Patricia Hewitt's claim that this had been the best year ever for the NHS.
'It has been a lousy year,' he claimed. 'The truth is that the obesity time bomb went off years ago: we are now waiting for the time bombs of diabetes, cancer and early death. We have been heading backwards this year: targets have been missed and future ones on childhood obesity will be missed. And we have gone one year closer to the bankruptcy of the NHS which is inevitable if obesity is not tackled.'
Ms Weyman said that pressure to meet the 48-hour target for access to genito-urinary medicine clinics meant that cash-strapped primary care trusts were cutting other sexual health services such as contraceptive clinics.
'More women are likely to have unplanned pregnancies and more will be at risk of infection,' she said. 'We will see more emotional costs and financial costs to the NHS.'
She called for money given to public health in the 2004 Choosing Health white paper to be ringfenced.
Conservative health spokesman Dr Andrew Murrison said a 48-hour GUM target was not enough. He called for immediate walk-in GUM healthcare.
'I am not a fan of quick and dirty walk-in centres but I think this is an area where there should be immediate access,' he said.