Only one in three GPs believe the new contract payment for Choose and Book to be introduced from April will encourage them to take part in the scheme.

A total of 36% of GPs questioned in a survey for GP newspaper reported that the directed enhanced service for choice and booking would make Choose and Book more attractive.

The same survey also found that only 40% of GPs in England are offering patients a choice of four or five hospitals and that 53% felt pressurised by their PCT to offer Choose and Book.

The survey, which was completed by 126 GPs, reported that six out of ten respondents had the Choose and Book software installed and, of those using the software, 25% of GPs make the bookings themselves.

This week’s issue of BMA News also focuses on the Choose and Book scheme and reports a series of problems and disincentives GPs face in taking part in the scheme.

Steve Mercer, chief executive of Avon LMC, told BMA news that his LMC has been "vigorously opposing" both Choose and Book, and manual choice while problems remained with workload, functionality and financing for the scheme.

He added: “That said, there are a very small number of pilot practices that have adopted full Choose and Book, and one or two seem to be enthusiastic when it runs well.

On the other hand, we know of at least one pilot practice that has withdrawn because the system is impossible and unreliable.”

LMC secretaries reported that many GPs had accepted the Choose and Book software and smartcards without planning to use it.

Dr Rob Barnett, Liverpool LMC secretary, said: “Quite a few practices have gone through the exercise of being signed up, but that appears to have been more through PCT persistence than anything else.

“At the last LMC meeting, one of the enthusiastic GPs said it had taken him 57 minutes to refer three patients through the system. This did not inspire other committee members.”

Latest figures from Connecting for Health show that 117,884 booking have now been made through Choose and Book to 15 February. A total of 9.5m outpatient apppintments are booked each year and the government’s target is for 90%  take up by March 2007.