GPs are calling on the government to exempt them from tax rises for employers announced at the Budget, warning it could hit services for patients.
The NHS and rest of the public sector are due to be shielded from a hike in National Insurance (NI) contributions from April next year.
But GP practices, which deliver NHS services but are mostly run as small businesses, are currently due to be hit by the rise.
The health department says further information for GPs will be announced in due course, although it is yet to offer details.
Private companies that deliver social care services have also warned about the impact of the NI hike, after it was confirmed they would also have to pay it.
Speaking earlier, Treasury minister Darren Jones said changes to the Employment Allowance – which allows some businesses to offset their NI bill – would shield smaller GP surgeries from the tax rise.
But professional associations have cast doubt on this claim, pointing out that businesses who do most of their work in the public sector are not eligible.
The Royal College of GPs has written to Health Secretary Wes Streeting, calling for GP surgeries to be protected from the rise by receiving the “necessary funding to cover these additional costs”.
Its chair, Prof Kamila Hawthorne, added that otherwise surgeries would have to look at making redundancies or even potentially closing down, meaning patients would “bear the brunt” of the tax hike.
Dr David Wrigley, a GP and deputy chair at the British Medical Association, also called for a “rapid announcement of full reimbursement”.
He added that the impact of the NI hike would be “monumental” for practices, many of which were “already on a financial tight rope”.
GP surgeries deliver NHS care under government contracts, mostly as business partnerships operated by multiple GPs working together.
This differs from other parts of the NHS, which will be protected from the rise under a wider public sector exemption worth around around £5bn a year.
The Liberal Democrats are calling for GPs, as well as companies running care homes and offering care to people in their homes, to be made exempt.
Speaking to reporters, leader Sir Ed Davey also said an exemption should cover pharmacists, adding the hike would “really hit” healthcare providers.
“They’ve exempted the hospitals, for example, they need to exempt the GPs and the pharmacists,” he added.
Mike Padgham, who chairs the Yorkshire-based Independent Care Group, said the NI rise could be the “last straw” for some providers in his area.
“The government has to do something and it has to do it quickly,” he added.
Downing Street said that an extra £600m in grants for local councils, who subsidise social care, would help “address pressures in the sector”.
