By David Crabtree, Sky News Correspondent
A third of GPs are in favour of making people pay if they make unnecessary visits to hard-pressed accident and emergency departments.
A new survey asked GPs whether people should pay £5 or £10 for each visit, with the money being refunded if their attendance was found to be justified.
The poll was carried out by the Press Association for Doctors.net.uk, an online network for doctors, and involved canvassing 800 GPs across England.
One in three (32%) family doctors said introducing patient fees for some visits would be the most cost effective way of cutting unnecessary A&E attendance.
Four in 10 (39%) said placing a GP surgery, with extended opening hours, adjacent to every emergency department would help reduce the numbers seeking A&E help and cut spiralling hospital admissions.
Another 11% thought more NHS walk-in centres would help ease the strain, while 8% believed that an improved 111 phone service - set up to replace NHS Direct - could provide the answer.
People using the Queen Elizabeth Hospital in Birmingham were sceptical about paying for A&E.
George Price said: "It might stop people going because of the cost and others might think that paying a tenner was a good deal to be seen by an A&E doctor, it sounds like a bad idea to me."
Carole Bailey, who was visiting a relative, had reservations about how it would work.
She said: "Who is going to say someone is wasting their time?
"Most people who go must think they are really ill and where do you draw the line?"
Dr Tim Ringrose, chief executive of Doctors.net.uk, said: "It may be a clear departure from the traditional NHS vision, but many doctors are now saying that radical action has to be taken to reverse the 'free at the point of abuse' culture that is a key contributor to the current emergency care crisis in some areas."
Helen Stokes-Lampard, from the Royal College of General Practitioners, said: "Charging patients for the use of emergency departments would put us on the slippery slope towards the Americanisation of healthcare - where only those who can afford it get the care and attention they need.
"Doctors have a duty to provide healthcare to patients regardless of their ability to pay.
"Patients seek healthcare when they are at their most vulnerable and if they attend A&E, it is usually because they don't know where else to turn.
"Emergency departments are really struggling but the way to solve the crisis is to adequately fund general practice, so that family doctors can provide more care for patients in the community.
"GPs conduct 90% of the NHS contacts for just 8.39% of the NHS budget.
"If general practice was better funded many people who are seen in emergency departments could be seen by a local GP."
The survey revealed the overwhelming majority believed changes announced by the Health Secretary Jeremy Hunt in November regarding GP contracts would do little to ease the pressure on A&E units.
It also found that three quarters of GPs (74%) disagreed that giving older people a named GP would cut the numbers ending up in A&E.
Just one in 10 doctors agreed this would help alleviate pressures on the system.
:: All next week Sky News will have live coverage examining the crisis in the NHS. Watch 'A Matter Of Life And Death' on Sky channel 501, Virgin Media channel 602, Freeview channel 82 and Freesat channel 202.
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