Kendal's three GP practices have reached saturation point and doctors are turning away potential new patients because they cannot cope with the increasing demand, reports Michaela Robinson-Tate.

For the first time, all three of the town's GP practices have been forced to close their lists to new patients, and say Kendal's burgeoning population is to blame.

Patients attempting to register are told the lists are full, and advised to call an agency in Preston which will allocate them to a practice, in order to ensure no one surgery is overwhelmed.

This not only removes the element of choice, but also potentially forces parents with young children, and those without transport, to travel across town to see a GP.

The problem has prompted health chiefs to query how long the system can continue to cope, and there have been calls for a fourth practice.

While health bosses work to try to boost GP coverage in the town, an expert panel has been set up to prevent a repeat of the difficulties.

Two of the surgeries say they were forced to shut their lists because of the sheer numbers of new patients, and Office for National Statistics figures show that the population of Kendal increased from 24,992 in 1991 to 27,521 in 2001 - a rise of 10.1 per cent.

At 8,200 patients, the two full-time and five part-time doctors at Captain French Lane now have 100 more people on their list than planned, although doctors will still make exceptions for some, including the elderly.

However, with 1,800 patients per full-time equivalent GP, practice manager Andy Robinson said they were already above the county average of around 1,680 patients per GP.

Mr Robinson said new housing was continuing to be built in the town: "Where are these patients going to register?

"If they move to this end of town, why do they have to go out to Helme Chase (James Cochrane surgery)? Maybe they have moved to one of the little ginnels in Kendal because they have not got a car.

The question is, possibly, should there be a fourth GP practice in Kendal?"

He feared large numbers of patients could prevent practices from meeting a Government target that by 2004 patients should be able to see a GP within 48 hours.

Practice manager at Station House Bronwen Glancy said they were forced to close their list because the installation of new computer and phone systems, and difficulties in recruiting administrative staff, left them without enough capacity to deal with new patients.

The 12,500 patients are treated by nine doctors, two of whom are full-time, although the practice hopes to increase GP time.

Mrs Glanc y said: "People aren't left doctor-less, I just think it's a bit stressful for them.

"We've never shut our list before and this is an absolute first.

It's not the way that we would operate on the whole and for us it's an exceptional circumstance."

James Cochrane practice manager Sue Blonsky said that, until recently, the practice was accepting patients from the southern side of town, because its Helme Chase surgery is the only one that serves that part of Kendal.

However, when the other two practices shut their lists, James Cochrane's numbers started to rise, and it was forced to follow suit.

The practice now has 14,800 patients between six partners and two part-time doctors and is continuing to be allocated eight or nine new patients each week from the Lancashire and South Cumbria Agency.

Mrs Blonksy said potential patients were "not happy", but the practice wanted to protect the quality of the service it provides.

Captain French Lane GP Dr Jim Gardner, who is chairman of the South Lakeland Local Health Group, said that GPs were now more involved in the management of conditions like diabetes, heart disease, and mental illness, and this had contributed to the average length of a consultation increasing from seven-and-a-half minutes to ten minutes over the last five years.

The population of Kendal was growing, and there had been an influx of older people into the town, who tended to have more problems to discuss with their GP.

Dr Gardner said that the local health group was working with one of the three practices to secure more doctor time and enable the GPs to open their list.

In addition Morecambe Bay Primary Care Trust has set up a GP practitioner panel, to include GPs, managers and lay members, who would look at population and try to predict demand proactively.

He questioned how long the allocation system would work: "Can they keep going on forever - one would assume not."

The four GP practices in Ulverston are still accepting new patients.

Cumbria and Lancashire Health Authority experts have not detected a pattern of GPs closing their lists across the region.