The pay of family doctors would be linked to patient satisfaction and treatment success under Conservative plans to give GPs greater control of National Health Service spending.
Conservative Health Spokesman Andrew Lansley, launching a wide-ranging NHS policy paper, said GPs were senior public servants who had "a responsibility for the use of resources to deliver the best outcome for all their patients."
"We are proposing to create a structure ... which incentivises GPs to deliver better outcomes and to recognise that their remuneration must be fundamentally geared to outcomes," he said. Lansley was careful to say he was not suggesting family doctors were overpaid.
In January, Health Secretary Patricia Hewitt sparked a furious row with GPs when she said family doctors were earning too much after a new performance-related pay contract left them on an average of 106,000 pounds a year. The Conservative plans would mean GPs controlling the bulk of the NHS budget, using the money to commission services from hospitals and other health providers.
Doctors' leaders have said they would broadly welcome Conservative proposals to focus on health outcomes rather than Labour's service targets. But they say the outcomes being measured need to take account of the differing healthcare needs of local areas and individual patients. The policy proposals aim to put substance behind party leader David Cameron's claim that the Conservatives have replaced Labour as the guardians of the NHS.
Central to the Conservative plans are the creation of an independent board to run the NHS, an idea floated by advisors to premier-in-waiting Gordon Brown last year but rejected last week by Health Secretary Hewitt. The board's membership would include lay appointees as well as medical, nursing and finance directors.
"They would have the responsibility to allocate resources fairly across the NHS, to try to deliver equitable access to services, and to set out national standards," said Lansley. The proposal for an independent board was welcomed by the NHS Confederation, which represents 90 percent of NHS organisations.
Elsewhere in the policy paper, the Conservatives said they would abolish the government's 18-week waiting time target between a GP referral and the start of specialist treatment. Lansley said the target was only relevant to a quarter of NHS patients and was distorting other health priorities. "We are proposing a structure that incentivises additional capacity and creates more information for patients and clinicians about how long they wait.