A motion was carried calling for additional support for struggling practices. Tayside LMC member Dr Steve Gardiner said the patient survey financially penalised practices that were already struggling.

'How a reduction in income is supposed to increase quality and access is not clear,' he said. 'The Scottish government should recognise that if a practice is struggling it needs extra funding to allow it to develop.'

But Lothian LMC member Dr Ian Johnson said there was a need for well-designed patient surveys: 'We have to ask patients if they think they are getting a good service, and we have to respond to that.'

LMCs rejected a motion calling for senior NHS managers to have a proportion of their income based on the results of a satisfaction questionnaire.

Dr Alan McDevitt, GPC Scotland joint deputy chairman, said: 'This may make you feel good. But as we hear how unfair it is to have such questionnaires it would seem wrong to impose that on other people.'