Figures suggest almost 600 fewer GP surgeries in England open at evenings and weekends than before 2010, Labour has claimed.
Health spokesman Andy Burnham said the coalition had created queues outside practices and diverted people to A&E.
Tory Health Secretary Jeremy Hunt said Labour's numbers were wrong and that out-of-hours cover was being extended.
The Lib Dems also said Labour's figures - obtained through a parliamentary question - were out of date.
Mr Burnham announced the analysis as his party unveiled a new poster, which reworks the Conservatives' "Labour isn't working" image of 1979 by depicting a huge queue outside a waiting room with the title: "The doctor can't see you now."
"On all the indicators it is clear that GP services have gone backwards in this Parliament," he told the BBC.
In other election developments:
- Nick Clegg will set out how the Lib Dems would use the proceeds from a crackdown on tax evasion to fund income tax cuts
- David Cameron will campaign in Scotland, Wales, Northern Ireland and England in a single day
- Tony Blair will enter the campaign for Labour with an attack on the Conservatives' Europe policy
- Research for BBC Scotland suggests voters in Scotland favour targeted public spending ahead of efforts to eliminate the deficit or cut taxes
- Nigel Farage dismisses calls from Mr Cameron for UKIP supporters to "come home" to the Conservatives
Policy guide: Health and care
This issue includes NHS funding, GP access and social care, particularly of older people.
Labour has pledged £2.5bn to pay for 8,000 more GPs, guaranteeing appointments within 48 hours.
Mr Burnham said the last Labour government had introduced an extended-hours scheme which, in 2009, funded 77% of surgeries to open on evenings and weekends.
The Commons answer suggested the coalition had reduced extended access funding in England from £3.01 per patient to £1.90 per patient, meaning that - by 2013/14 - 72% of surgeries offered extended hours under the scheme, a reduction of 590, according to Labour's interpretation.
Mr Burnham told BBC Radio 4's Today programme that many people were not able to book appointments for days and, as a result, ended up at A&E. "If you are going to have a truly preventative NHS, you have to make sure people can get the right care at the right hours."
He said he did not blame GPs, who he suggested had been "demoralised" by budget cuts - adding that Labour would also seek to reverse closures of walk-in centres and ensure the non-emergency 111 helpline had more experienced medical staff.
But Health Secretary Jeremy Hunt said Labour's figures were wrong, because they did not take into account the Prime Minister's Challenge Fund, which covers 1,100 practices and helps 7.5 million patients see a GP in the evenings and at weekends.
"We are extending this scheme to cover over 1,400 additional practices, helping 10 million extra people by this time next year," he said, adding that a Conservative government would deliver "a truly seven-day NHS".
Pilot schemes paid for by this fund include those testing approaches such as the use of technology, health apps, and allowing access to services by video call, email or telephone.
Mr Burnham told Sky News most patients were not seeing any benefit from the Challenge Fund, suggesting it was only dealing with "a minority" of practices and patients.
Mr Hunt blamed Labour's "disastrous" renegotiation of the NHS contract for GPs in 2004 for creating the problem, which Conservatives say "meant 90% of GPs stopped giving out-of-hours care".
The Lib Dems also pointed to a £50m GP Access Fund, which they say helped 1,147 practices to extend their hours last year.
Party election spokesman Lord Scriven said: "The Liberal Democrats are the only party prepared to commit to spending the £8bn extra the NHS says it needs to survive."
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Are you affected by the issues in this story? Email haveyoursay@bbc.co.uk with your stories. If you would be happy to speak further to a BBC journalist, please include a contact telephone number.
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