In a 2005 letter, the government's second ranking finance minister, chief secretary to the treasury Des Browne, advised then-health secretary Patricia Hewitt that GMS contract negotiations should be used to put pressure on practice income.

‘Given the significant increases in GP profits over the past three years, the renegotiation provides us with an opportunity to moderate the current financial pressures which the NHS is facing,' he wrote. 

The letter dates from November 2005, just 18 months after the new contract came into force. Three years of pay freezes for GPs followed.

A DoH spokesman said: ‘The letter sets out the position of Her Majesty's Treasury. This was accepted by the government and we have sought to deliver on this over the past three years.' 

Laurence Slavin, a medical accountant with Ramsey Brown and Partners, said that if the Treasury wanted to fix the financial chaos in the NHS, ‘it's looking in the wrong place'.

‘GPs tend to be quite efficient - that's why they outperform the government's expectations,' he said. 

jonn.elledge@haymarket.com

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