Concerned GPs last night warned that rural patients could be hit if health chiefs press ahead with plans to cut funding for blood tests.Norfolk Primary Care Trust wants to slash payments to doctors for the non-essential or "enhanced" phlebotomy service from £1.

Concerned GPs last night warned that rural patients could be hit if health chiefs press ahead with plans to cut funding for blood tests.

Norfolk Primary Care Trust wants to slash payments to doctors for the non-essential or "enhanced" phlebotomy service from £1.12 per test to 47p as part of a wide-ranging cost-cutting drive to slash its £40m debt.

But doctors fear the move will mean patients in rural areas will miss out and they accused the Trust of adopting a "take it or leave it approach" to the proposal.

The Trust set out its plans less than a month ago and doctors have until today to respond. Under the proposals GPs either accept the lower funding figure, or stop offering the tests and refer patients elsewhere for the tests

Dr Gordon Manson-Bahr, who runs the Long Stratton Medical Partnership, said the implications had not been thought through.

While many in urban areas could go to nearby community hospitals for the tests, rural patients would find it harder to access the service. And there would be increased delays and waiting times because patients would not get an instant result.

"It's a bullying tactic," he said. "They've already said with flu jabs that they are not going to pay us unless we bought the vaccine from the PCT. A lot of doctors are frightened and the PCT won't respond directly.

"They are spending £3m with Bupa trying to get their waiting lists down, but we are talking about something which costs £8,000 a year.

"We are in the 21st century, this is what we should be doing. We are happy to accept a reduction but not more than 80p per person. Patients want to go to the doctor and get the results as quickly as possible."

Dr Ian Hume, chairman of the Norfolk Medical Council, urged the PCT to rethink its proposal.

"What's on the table is a third of the funding to provide the service. If you are employing staff it's difficult to absorb that sort of cut without it having an effect on patients," he said.

But Dr John Battersby, director of public health at Norfolk PCT said the new rate was based on the one paid by the former Broadland PCT in which GPs in that area undertook all their phlebotomy and were charged for any blood tests taken at alternative locations such as a walk-in centre.

"As GPs were already providing the service at this rate we felt that this was a pragmatic way forward," he said. "GPs have had the new specification to consider for nearly three weeks and will be paid their current rates until the end of March. This is a one-year proposal during which we want to work closely with practices and the Local Medical Committee, both to collect more accurate data and to agree quality and value-for-money services.

"When we have a clearer idea which practices will stop providing this service to their patients, we have plans to introduce a complementary service which is likely to be provided through community health centres. We recognise services in rural areas need to be as accessible as they are. District nurses already take samples from patients who are unable to get into their practice and this will continue."