Cuts to NHS pensions will further deepen the gloom for GPs, but Dr Buckman predicts that the issue is unlikely to see GPs go out on strike this year.
He warns that the financial environment in the NHS is ‘very serious’, with little prospect of improvement.
Many practices may be forced to let staff go as the financial situation worsens, he says. ‘I think many practices are struggling. The surge in income straight after the new contract has gone now.
‘A lot of practices are going to think very seriously about how they will hold on to all staff. I hope they can but I recognise they may find that difficult.’
Dr Buckman warned at the start of 2011 that GPs could be forced to ‘sell out’ to the private sector, allowing companies to take over their practices, as NHS cuts bite. He says it is too early to judge the extent to which this fear has materialised, but admits it remains a threat for 2012.
Across England this year, clinical commissioning groups (CCGs) will be carrying out the bulk of preparatory work for authorisation in 2013. Dr Buckman says it is vital for GPs to seize the commissioning agenda and ensure they are involved in CCGs this year.
He says: ‘GPs must be involved, otherwise the initiative might be seized for them, and in directions they might not particularly want.’
But Dr Buckman warns that a significant number of CCGs may not be fit for purpose by 2013 because of a shortage of funding. He says some CCGs may fail to be authorised altogether, leaving the NHS Commissioning Board to commission in their place. He admits this is undesirable, but argues that it is preferable to a private company taking control. ‘I don’t want central control, but I would rather that than someone operating from Paris or Chicago.’
Although the financial situation will make life difficult for practices in 2012, Dr Buckman says tight NHS funding will limit changes to the GP contract. The 2013/14 deal is unlikely to change much from the 2012/13 model, he says.
Pension reforms proposed by the government are ‘astonishingly bad news’ for young GPs, Dr Buckman says, and for the profession as a whole. But strike action remains unlikely.
‘Striking is not generally an option doctors will leap to as their first thought,’ he says. ‘I’m self-employed, so all it means is that I’m going to damage patient services. Well, I’m not going to do that.’
Although the coming year looks daunting for GPs, given the raft of changes on multiple fronts, Dr Buckman says 2012 will simply be one more challenge in a long list that the profession has faced up to in previous years.
‘I’ve been through an awful lot of reorganisations before and this is just another one,’ he says. ‘There will always be people who are not well and people who know how to look after them.’