Dr Laurence Buckman remains hopeful that GPC negotiators can 'soften the worst edges' of sweeping changes to the GP contract that the government plans to impose from 2013.
The GPC chairman draws hope too from positive noises on premises improvement from the DH, and his sense that increased scrutiny for GPs through revalidation and CQC checks may prove less onerous than many fear.
But contract changes that would axe MPIG top-ups to core funding and trigger the biggest overhaul of the QOF since it began have cast a shadow over his view of what the year ahead holds for general practice.
Speaking exclusively to GP, Dr Buckman says the GPC will meet DH officials during the consultation on the changes, which runs until 26 February. But talks remain on hold – he makes clear this is 'not a negotiation'.
|DR LAURENCE BUCKMAN|
If the proposals go ahead, he says, many practices will be unable to afford to keep all of their staff.
A mass walk-out from general practice is unlikely, but people near or above retirement age will quit in a 'slow trickle', he says.
'Patient access will diminish, because you can't do all this stuff in a normal working day,' he adds. 'It is impossible. Something has to give.'
If all else fails, is industrial action an option?
'It is never not an option, but I cannot say that it is a particularly attractive one. I don't think GPs will go on strike or take action,' he says.
The fact that GPC Scotland struck a deal with the devolved government on the GP contract, and that Wales and Northern Ireland may follow suit, will mean more work for the GPC. But it will carry on negotiating as a UK body, he says.
'We have always had autonomy within the Celtic nations for Celtic matters,' he says. 'Now they have a bit more autonomy.'
One issue on which Dr Buckman believes the UK government is beginning to listen to the GPC is premises.
He says ministers are 'showing considerable willingness' to solve the problem of GPs being unable to borrow money to invest in premises.
'They know you can't do more in the community if you haven't got a place to do it,' he says. 'We are going to have to work with them to find a solution to the borrowing problem at the heart of all of this.'
Revalidation and CQC
Two issues that have caused anxiety for GPs in 2012 – revalidation and CQC registration – may not be as burdensome as initially feared, Dr Buckman believes.
Last month he was recommended for revalidation by his responsible officer. The process was 'not too bad', he says. He tells GPs: 'Don't worry. Just regard it as a normal appraisal with some extra paperwork.'
Dr Buckman took part in a CQC registration pilot last year and says that too is straightforward. 'There will be things you can't do and the inspectors are told to be gentle on that,' he says. 'If you can't create a disabled toilet in your building, you can't.'
Where England's NHS reforms are concerned, 'the worst is yet to come', Dr Buckman warns. CCGs will be forced to ration care even more than PCTs. But he does not advocate withdrawal from GP commissioning.
'We shall be working with CCGs and supporting them, not just pretending they will go away if we make a loud enough noise,' he says.
He admits CCGs could provide a new 'political opportunity' for GPs to get involved in service redesign and change services they have long complained to PCTs about.
Despite glimmers of hope, 2013 will be a tough time for practices. So what do GPs have to look forward to?
'Their patients. Being a GP is very enjoyable and hugely rewarding. Most people do this job because they like it. There are 2,000 punters out there who love me and I like that.'
How does the GPC plan to champion general practice in 2013? 'By making a lot of noise,' he says. 'We will continue to put out a positive message about what GPs do and what they could do.'