Health secretary Alan Johnson has written to GPs advising them to accept the deal the BMA rejected before Christmas or risk losing up to£35,000 of practice income.

The deal would require the practices to provide an extra 30 minutes consultation time per week per 1,000 patients (around 3 hours for the average practice) in return for a 1.5% rise in practice income.

If GPs fail to accept the offer, Mr Johnson intends to give primary care trusts powers “to make better use of some of the resources in the contract (around£35,000 for an average sized practice” in consultation with patients.

This would include resources linked to the access and choice directed enhanced services, the quality and outcomes framework local patient surveys and a number of out-of-date or duplicative QOF indicators.

Mr Johnson said: “We would encourage GP practices to discuss with their PCT how to take forward improvements in extended hours, either under the proposed national framework or under locally agreed arrangements.”

The DH takes the view that the current BMA leadership no longer represents the views of the wider GP profession,

Dr Laurence Buckman chairman of the BMA’s GP committee denies this, saying this is why the BMA is polling GPs’ opinion on the offer. “The BMA never rejected the government’s offer, but we couldn’t accept it on behalf of the profession without making certain that we are representing what they think,” he said.

“We are being contacted all the time by GPs who are angry and upset about the bullying behaviour of the government and who fear that the government’s plans will damage general practice in this country.”