General practice needs a radical new funding system and improved flexibility in rules around primary care networks, campaigners have said.

The Doctors’ Association has set out a series of proposals in a letter to new Health Secretary Therese Coffey, calling for “huge investment” in general practice. The association says that up to 16 million people will find they do not have a GP without the investment in primary care. GPs are facing “unrealistic demands” that make them quit the profession or leave the country, it says.

The association proposes that practices should be paid by the number of patient contacts rather than by the number of patients. It wants primary care networks to have full discretion in using their funding, meaning they could invest more in GPs and nurses if it was feasible – rather than in pharmacists and physiotherapists. GPs should also have paid administrative time – as hospital doctors do, the association says.

GP lead Dr Lizzie Toberty said: “We are hurtling rapidly towards the end of the NHS as we know it, where those who can pay – and those who can’t suffer. And just like in dentistry, there is evidence of a rapidly expanding private GP sector. For those who cannot pay, my worry is they will die young of entirely preventable diseases. We are about to see health inequalities get a whole lot wider.”