The government should extend its patient choice programme to GPs as well as hospitals, according to the Social Market Foundation (SMF).

A report from the SMF's healthcare commission called for wide-ranging changes in the way in which patients choose their family doctors.

With some 80 per cent of treatments taking place in GP surgeries, the study said that introducing choice into the sector could make a bigger impact than just introducing it for hospital operations.

It called for reform to the current "catchment area" basis on which patients are allocated to a GP practice.

The system is hindering the development of a modern and responsive NHS, said the commission.

"The catchment area system dates back to the inception of the NHS, when it was assumed most patients would walk to the surgery, and that doctors would be making a lot of home visits. Both assumptions no longer apply," said commission chairman Lord Lipsey.

"If we allow patients a freer choice of which practice to join, including practices in other primary care trusts, this could function as a considerable incentive to GP practices to use their new powers to the full, including their powers to purchase services for their patients.

"Furthermore, there is considerable evidence to suggest this relaxation in registration requirements would come as a great boon to the many patients who still experience difficulty in registering with a practice they find suitable."

Nurses

The report also called for GP practices to be given the choice of which primary care trust to join, and allowing practice nurses to act as the first port of call for many patients.

"The so-called 'patient choice agenda' has up until now been focussed on NHS hospital care," said Lord Lipsey.

"GP care, however, is where 80 per cent of treatment episodes begin and end.

"Taken together, the reforms proposed by my commission hold out the promise of a high-quality patient-centered GP service for all NHS patients."