By Nick Triggle BBC News health reporter

The large practices of the future will provide a whole range of services such as minor surgery, heart checks and diabetes clinics previously carried out in hospitals, supporters say.

But critics point out that patients often like the personalised service they get at smaller practices.

Two family doctors - one who works on his own and another from a large practice - speak about what they see as the pros and cons.

Dr Rawes set up on his own after a lifetime working in group practices

Dr Geoff Rawes made the move from a large group practice to having his own surgery in 1997.

"I wish I had done it 15 years earlier," he said. "It was the best thing I have ever done.

"From a patient point of view, I think the service is much better. You get a personalised service and continuity of care, I know my patients, I know their medical history, and I think they trust me."

The surgery in Blyth, a former mining and shipbuilding town in Northumberland, covers an area with high levels of deprivation and unemployment, with stroke deaths well above the national average.

Dr Rawes, who has been a GP for 33 years, said: "There are issues about patients taking responsibility for their own health, and I think the nature of our surgery helps with this.

"As a single-handed GP I and my staff are able to convince patients to take more interest in their health.

"Patients know the nurse, know the receptionists, and know me. They are willing to listen, and that is important when you are trying to encourage a change in behaviour."

Checks

Each year the surgery's 2,200 patients are weighed and have their blood pressure checked - some of which are done by the four receptionists.

"We are able to do this because there is not a huge throughput of patients that you would see in a large service.

He also believes recent reforms of the NHS have helped him to improve the service the surgery provides.

Last year GPs were allowed to opt out of providing out-of-hours services under a new contract.

SURGERY STATISTICS There are more than 31,000 GPs in England and Wales About 2,800 work in single-handed practices A similar number work in two-doctor surgeries There are 6,000 larger practices, most with three to five GPs

"Before, when I was doing a night shift, I would finish at 8am and then be back in the surgery at 8.30am.

"I don't think that is the best way to care for patients.

"I decided to stop doing the cover and it now means GPs such as myself can devote more energies to day surgery."

However, Dr Rawes, who is in his 60s, acknowledges there are some disadvantages to being the only GP in a practice.

"You cannot share the workload like you can in a group practice and it means taking holidays can be tricky.

"And, of course, we cannot provide the broad range of services a large practice can, although we are based at a hospital which offers diabetes screening, X-rays and physiotherapy, so patients have easy access to those.

"Saying that, in all our surveys patients say they are happy with the service they are getting, I don't think they would change."

Dr Kohli used to work in a small terrace surgery

The Centre Manor Park surgery opened in Newham, east London, in November with much fanfare.

Health Secretary John Reid was on hand to hail the "super surgery" as the vision for the future.

The �4.9m centre - it actually contains three individual practices with a total of seven family doctors and five nurses - offers a whole range of services, a far cry from the traditional terrace GP surgery.

There is a diagnostic suite for heart scans, ultrasounds, X-rays and blood testing, and a pharamacy and opticians are on their way.

The doctors have also teamed up with a community group to offer complementary medicine, including reflexology and Chinese massage.

There is even room for a dental surgery - although as yet no-one has been employed.

Dr Bhupinder Kohli said: "I really believe this is the way forward. I came from an old two-person terrace practice, and it is unbelievable what we can do here.

"The idea is that you provide more services in the community so patients are less likely to need to go to hospital where they can face long waits.

When you look at the services on offer, the speed people go through the system, there are immense benefits Dr Bhupinder Kohli

"In particular, people have struggled to get diagnosed in the past, so having a diagnostic suite is a real bonus."

And Dr Kohli said the new facilities and modern services also mean it is easier to recruit and attract staff.

"The recruitment benefits should not be over-looked, in London it can often be a problem. But we have a young, ambitious and enthusiastic team that really wants to make a difference."

But the 43-year-old admitted some of the centre's 15,000 patients have had doubts, but he believes they will soon be convinced about the services on offer

"For some patients it is a different type of service and, like anything, it takes a while to get used to.

"There is obviously not the continuity of care you can get with smaller practices.

"But I am not convinced that the level of service you receive is better in a single-handed practice.

"When you look at the services on offer, the speed people go through the system, there are immense benefits."