For a start, they have to negotiate with a government which has a reputation for deviousness, hidden agendas and spin. Any agreement will be regarded as fixed and contractual - only for the DoH to change it unilaterally whenever it suits it, wrong-footing our representatives yet again.
Just to make things even worse, our negotiators know they have little GP support over the ultimate sanction of withdrawal of labour. Our negotiators may look impressive but in reality the emperor has very few clothes.
Yet the politicians still regard the BMA as a formidably intransigent union. In part this is because doctors historically have had massive support from the public. Our negotiators may have little real muscle and many of their threats will be based on bluff, but the DoH knows that if they upset the doctors, they also upset a good proportion of the population.
Until recently, that is. I'm convinced that the DoH's repeated and misleading publicity about GPs' 'excessive' pay is intended to undermine us in the public eye so that when the hammer descends, we will already be deprived of national support. You only have to read certain columnists in the popular press to realise how well this strategy is working.
What is the government's hidden agenda likely to be? Privatisation? Probably not -that argument is behind us. We will be asked to extend our opening hours. A much nastier scenario would be the complete renegotiation of MPIG and PMS, allowing the government to claim that they could remove the NHS deficit at a stroke by redistributing income from 'overpaid' GPs.
In the current climate of negative publicity, the nation will accept this all too easily, and deny our negotiators the very real public sympathy they have enjoyed in the past.
Our negotiators will therefore be entering the next round of discussions in the weakest possible position, only too aware that they have all eyes upon them, poor support from GPs for direct action and little public backing.
It's not a good place to start - yet there is a lot we can do to strengthen their hand: more on this next week.
- Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com