The Royal College of General Practitioners (RCGP) has warned that the scale and pace of change contained in the government’s health White Paper risks leaving GPs at ‘breaking point’.

In its response to the White Paper, the RCGP warns that ‘members have expressed concerns that the scale in which changes needed to be made is not justifiable, especially in the context of cost reductions’ and there are concerns that ‘the proposed scale, pace and cost of change will prove disruptive’.

Its response states: ‘There are concerns that the GP workforce will be stretched to breaking-point without adequate support, which would be disastrous for patient care.’

The RCGP also reiterates opposition to patients’ free choice of GP practice, saying it would be ‘damaging in terms of continuity of care, health inequalities and potentially, patient safety’ and ‘very likely threaten the viability of some practices, especially rural practices that provide a vital service to patients who are less mobile and potentially more vulnerable’ to changes in service reconfiguration.

The College has urged health secretary Lansley to think again about the timeframe for the changes, allowing GPs to learn from existing managers before PCTs are axed and with some members calling for PCTs to stay, albeit with more GP involvement.

If GPs are left to run NHS commissioning without adequate support, it says, the result would be a ‘disaster’ for patient care.

Long-serving GPs fear government plans may have damaging repercussions for the doctor–patient relationship.

Meanwhile a survey has confirmed that student doctors and nurses are fearful that the government’s ‘reform plans for the NHS will harm patient care.

Some 45 per cent of those asked said that they fear the government’s restructuring plans will destabilise the NHS for years to come.

Only 18 per cent said that the proposed £20bn savings can be achieved without adversely affecting the quality of patient care, compared with 58 per cent who disagree.

The online survey, conducted by Ipsos MORI Social Research Institute on behalf of private health insurance company AXA PPP, involved 153 students of medicine, nursing and midwifery.

The students expected there to be considerable downsides from the replacement of primary care trusts with GP-led commissioning: 58 per cent thought that GPs will spend more time on paperwork under the plans.