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NHS managers are calling on the Government to allow patients to decide the length of their GP appointment, writes Emily Wright.

The NHS Confederation's submission to the consultation on the community health White Paper said the move was key to giving patients more control over their care.

Jo Webber, deputy policy director at the NHS Confederation, said patients would become more upfront with GPs about their needs if they specified the length of appointment.

She said: 'It will stop patients using one problem to get through the door and trying to fit in as many more as possible once they are in with the GP. This should mean that surgeries are less likely to overrun.'

But GPs argued the move would place them under even greater strain.

Dr Andrew Oakenfull, a GP in Durham, said it would be difficult to apply in an under-doctored system.

He said: 'Maybe some patients would want shorter consultations but I imagine a lot will want longer ones. We are already doing as much as we can.'

Dr Richard Wright, a GP in Colchester, said: 'If patients come in with a great long list, there will only be a limited number of people we can get through in a day.'

The NHS Confederation also said smaller practices would have to band together to provide the level of service required by patients, and patients should have freedom to move practices.

But the confederation warned the Government's agenda of increasing competition had 'a significant danger of creating a large supplier-induced demand for minor conditions'.

GPs agreed that patients would make more use of the NHS if the number of health care outlets continued to increase.

Dr Oakenfull said people would stop thinking about whether they really needed to use a service if access was unrestricted.

Dr Alan Dove, a GP in Northumberland, said most patients were not in a position to make appropriate choices between providers.

He said: 'It's all very well saying "the patient has a choice" but the patient may not know what is in his/her best interests. That's why I spent all those years at medical school and 35 years practising since.'

What managers want

· Open up market to allow entry of new providers, including through venture capital investment

· Regulate 'restrictive' behaviour by GPs

· Let patients set their own length of appointment

· Longer consultation times with GPs

· Allow some patients to go direct to specialists

· More patient surveys and link results to doctors' pay

· More group consultations

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