More than 1,000 Kent doctors face annual reviews to weed out poor performers in one of the biggest shake-ups of the medical system for 150 years.

GPs, hospital consultants and private practitioners would have to renew their licences every five years according to plans published today by the Chief Medical Officer Sir Liam Donaldson.

But critics fear more bureaucracy could divert doctors from patient care.

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David Barr, clerk from the Kent Local Medical Committee, which represents the 1,200 GPs in the county, said: "In principle, we wouldn't oppose the measures. However, it must be supportive to doctors and not punitive.

"A proper system is necessary to make sure patients have confidence in doctors - but we don't want a cumbersome one, otherwise patients will suffer."

Reaction from Kent GPs:

Doctors are already appraised annually by their Primary Care Trust, but the new system would also cover hospital doctors.

Dr Julian Spinks, of Courtview Surgery at Strood, near Rochester, said: "This isn’t going to be a problem for doctors that keep up to date and practise good medicine - and I would hope I’m doing that."

His main concern was the new system being overly bureaucratic. "I already spend a lot of time preparing for my current appraisals and there is a danger of eating into patient care time," he explained.

"But I hope we can avoid this - however, until we start to use it, we won’t know the impact on day-to-day practices."

~ Listen: Dr Spinks speaks to KentOnline's Sinead Hanna about the proposed changes >>>

Dr Rob Sadler - who is the chairman of the Kent LCM and practises at the Montefiore Medical Centre, Ramsgate - said: "There is a risk of it becoming intrusive.

"PCTs already collect evidence on GPs and can suspend them on that basis. In east Kent there are 25 doctors who appraise each other annually and there is the risk of making that process too much of an assessment.

"The current system is supportive and developmental. The new one could be seen as a threat and doctors may not be as open about how they're performing."

Dr Laurence Logan, from Faversham Health Centre, agreed and added: "I have no problem with the concept of GP assessment.

"But I’m concerned by the practical implications - I hope it won't be too bureaucratic or time-consuming."

The details of Sir Liam's report: