Family doctors have been warned that unless they agree to open at evenings and on Saturdays, private companies will be contracted to take over their practices.
A letter sent to local NHS organisations has ordered them to improve surgeries' responsiveness to the public, along with people's access to and choice of GP services. This includes the option of seeking alternative providers, including private companies, instead of GPs.
The Times understands that the letter, from Mark Britnell, Director of Commissioning at the Department of Health, was altered before being sent to tone down references to "competitive tendering" – which would include offering GP contracts to private sector companies.
But doctors' leaders said that the final draft sent to health trusts remained "very aggressively-worded" and a clear sign of a government mission to bring more private practice into the NHS.