The Liberal Democrats have called for an end to the smoking cessation element of the quality framework (QOF).
Currently practices receive QOF points for registering whether patients smoke, whether they have any conditions linked to smoking, and for offering literature and support to those who want to quit.
But speaking at last week's Reform event Norman Lamb, the Liberal Democrat health spokesman, said that this did not go far enough.
'QOF has had some success, but it is not really tied enough to its objectives,' Mr Lamb told the conference.
He described payment for telling patients to quit smoking as 'crazy'.
'There should be payments when people actually quit, and nothing less,' he insisted.
Mr Lamb was similarly critical of Payment by Results, the tariff mechanism by which PCTs pay hospitals for services, which he described as 'payment by activity'.
He also repeated his party's proposals to decentralise power in the NHS to local boards, describing it as 'competitive localism'.
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