GPs would be 'directly involved' in providing out-of-hours care under a Liberal Democrat government, the party's leader Nick Clegg has pledged.

In the Liberal Democrat election manifesto, the party also promised to link GP pay to health prevention measures to improve public health.

It also plans to reform GP pay so those who accept patients from areas with the worst health and deprivation scores receive extra funding for each patient.

Mr Clegg promised to make it illegal for a local health board - the name the party plans to give to PCTs - to allow a doctor to work in the UK without passing robust language and competence tests.

The manifesto also set out plans to end any 'bias in favour of private providers' by allowing local health boards the freedom to commission services from a range of providers, including staff co-operatives.

Meanwhile, it confirmed plans to give every patient the right to choose to register with the GP they want, as well as the right to contact their GP by email.

BMA chairman Dr Hamish Meldrum said: 'Enabling patients to register with any GP and not be restricted by where they live might seem attractive, but there are many problems and it is important that quality of care is not damaged.'

Mr Clegg said his first priority was to increase spending in some parts of the NHS by cutting waste in others.

'We have identified savings that can be made in management, bureaucracy and quangos, and we will reinvest money back into the health care you need,' he said.

'The NHS is a huge system, and we will make changes to ensure it works as effectively as possible.

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