The health service is guaranteed funding increases until 2010/11, but what happens then? Niall Dickson, chief executive of The King's Fund thinks that money will become much tighter. He predicts a very small, or even zero, increase in funding in 2011, and thinks the DoH will become focused on finding cheaper forms of provision.
No doubt this means a greater emphasis on 'skill mix', with other professions taking on many of the tasks currently carried out by doctors, and more use of support workers.
It is not just the government embracing this idea. Providers are also keen, among them the company run by a former chairman and deputy chairman of the GPC, Concordia Health, which employs huge numbers of nurses and very few doctors.
Despite assurances from health secretary Alan Johnson that the NHS is protected from the credit crunch (GP, 14 November), it seems that the recession will have an impact.
As with other sectors, one of the groups most affected by a downturn will be those at the start of their careers. We already know that the next generation of GPs is struggling to find employment, in particular partnerships. GPC chairman Dr Laurence Buckman has warned this is the greatest threat to the profession's future.
Uncertainties about funding in general practice and worries about the private sector's expanding role make practices reluctant to take on new partners.
Meanwhile, the economies of supply and demand suggest that if there is a surplus of GPs the government and health providers may see an opportunity to pay them less.
These are challenging times for GPs at the start of their career. This week, GP and our website, Healthcare Republic, launch our Young GP Forum as part of our GP35 initiative. It will give young GPs the opportunity to talk about the issues that matter to them and for more experienced GPs to offer them advice.
We hope this will help support young GPs as they deal with any obstacles they face.
More opinion online
Read more opinion from the GP editorial team in the editor's blog at www.healthcarerepublic.com/blogs. This is what the team had to say this week
- The DoH's 'Healthy Towns' scheme I love Tower Hamlets' award scheme to encourage local businesses to sell healthy food. If healthy options are readily available in most shops and cafes, and clearly labelled as such, people have fewer excuses for ignoring them.
- Medical researchers could have direct access to patient records We would lose ethical checks and balances on patient confidentiality to boost some ill-defined factor of competitiveness in the international research market.