A survey of over 23,000 GPs has shown that a quarter are ready to quit their jobs amid anger over workload and stress.

The British Medical Association survey will add to the pressure on the government to improve conditions for NHS staff and comes as ministers are about to begin negotiations on a new contract with family doctors.

The findings also indicate the extent of the recruitment problem facing the NHS, with 46 per cent of those questioned saying they would not recommend general practice to an undergraduate or junior doctor.

The survey, the biggest GP consultation exercise for a decade, shows that 27.8 per cent are considering a career change outside general practice either very or fairly seriously.

The dissatisfaction with employment conditions is highlighted by the findings that 20.7 per cent of GPs find their work-related stress is both excessive and unmanageable and a further 60.9 per cent find it excessive but manageable.

Almost half, 48 per cent, are calling for a reduction in the number of hours they have to work.

The keys to GP retention, suggests the survey, are increased income, favoured by 32 per cent, and enhanced pension rights, backed by 28 per cent.

The BMA survey also finds that GPs are sceptical about the impact of recent changes in the NHS.

While more than half think the new primary care organisations have helped local GPs cooperate better and given them a greater say in local health services, only a quarter think they have improved standards of care.

More bad news for the government came with the finding that over 80 per cent of GPs feel the government's plans for the NHS are not achievable in the timescales proposed. Sixty five per cent are not convinced the plans will improve patient care, while 90 per cent believe the government will struggle to recruit enough extra nurses in the next five years to make a substantial difference.

While the government will take comfort from the news that 53 per cent believe patient care in general practice is better than it was five years ago, there will be concern that only 45 per cent of GPs think a comprehensive NHS is achievable.

Relations between GPs and the government have already been hit by delays in negotiating the new contracts. A BMA ballot has already found that more than half of GPs would be ready to resign from the NHS if new contracts are not in place by next April.

Family doctors want new contracts to reflect their increased workload and new responsibilities, while safeguarding the BMA's right to negotiate nationally with the government on behalf of the whole profession.

Dr John Chisholm, chairman of the BMA's General Practitioners Committee, said the survey showed "a profession in poor heart" and said GPs were paying an unacceptable personal price for their commitment.

"Family doctors are leading change in primary care, offering a record range of services to patients, and are completely committed to providing high quality care to their patients. But they feel burnt out and exhausted and they are looking for early retirement or a change of career," said Chisholm.

"The message has come through loud and clear from Britain's family doctors. We need to curb the excessive demands on them and provide them with a contract which restores their faith in the future," he added.