Angry GPs are demanding further concessions on the structure, make up and resourcing of primary care groups, despite written guarantees from health minister Alan Milburn.

The British Medical Association's local medical committees conference last week heard from GPs across the UK expressing concern that PCGs would leave them responsible for rationing.

They are also demanding an increase in the proposed management allowance of pounds 3 per patient which they say is not enough to provide proper resourcing.

But motions calling for industrial action or non-co-operation with the PCG formation process were defeated.

BMA general medical services committee chair John Chisholm told delegates they should 'seize the chance' contained in Mr Milburn's letter guaranteeing GPs' independence and the choice of a hands-on or back-seat role in PCGs.

Dr Chisholm said the NHS Confederation and the Institute of Health Services Management were 'completely incandescent' that GPs had secured such guarantees.

'Non-co-operation will push us into open conflict with the government about its flagship policy - the rebuilding of the NHS,' he told GP representatives.

The conference called on GMSC negotiators to demand a lead role for local medical committees in developing PCGs and primary care trusts, arguing LMCs should have a place on their boards.

It went on to call for a 'true choice of entry into PCGs' and instructed the GMSC to 'negotiate to reverse the consequences of PCG levels one and two being sub-committees of health authorities'.

See News Focus, page 11.