In his speech to the RCGP conference in Glasgow, health minister Mike O'Brien said the college backed the move, prompting boos from the audience.

But Professor Field said that he and GPC chairman Dr Laurence Buckman had talked to the DoH about helping patients who spend a lot of time away from home gain access to GPs.

'We said we would work with them to find some solutions, but we do not support the abolition of practice boundaries,' he said.

Dr Chris Walker, a GP from Wolverhampton, was applauded when he told Mr O'Brien: 'I welcome the emphasis on quality care and resources put into primary care but I'm concerned by the end of practice boundaries within the next 12 months.

'If we lose practice boundaries, how are we going to visit patients?'

Mr O'Brien said it was unlikely that large numbers of patients would switch practices.

'But some people, particularly young people, who are working in big cities with GPs on the outskirts may want a GP in the centre because that's where they spend most of their time.'

He said daytime out-of-hours bodies may be able to deliver home visits a long way from practices. To laughter, he said: 'I feel a sense of concern about this all.'

Professor Field also said GPs needed to take more of a leadership role. In a time of economic crisis, which would see NHS funding squeezed, general practice needed to be about 'leadership, leadership, leadership'.

He said DoH management costs were 'scandalous' and should be slashed. In 2005/6 the DoH spent £205 million on management consultants, and £132 million in 2006/7. Professor Field said the money could be better used in primary care.

He called for leadership to be put 'back in the local economy'. 'Let us get clinicians leading because we are closest to our patients,' he said.

• For exclusive videos and further coverage of the 2009 RCGP conference, visit healthcarerepublic.com/rcgp