Risks Of Conservative Health Policy
Risk | Who affected | Likelihood | When | Severity | Source |
Wasteful redundancy of people who are then re-employed | PCT/HA staffNHS budget | 90% | 2011-14 | £2/3 billion | K. Walshe BMJ |
Disruptive effect on NHS organisations | 99% | 2010-5 | |||
Poor commissioning decisions by inexperienced staff – poor leadership, enthusiasts with ideas not backed by evidence | Population generally | 50% | 2014 | ||
Poor or corrupt commissioning decisions by commercial organisations | Population generally | ||||
Most GPs excluded by conflict of interest | 2013- | ||||
Longer waiting times | Elective surgical patients | 2012- | |||
Exclusion from decision making | Clinicians other than GP prinicipals | 2012- | |||
Erosion of comprehensive service | Patients generally | 2015 | |||
Erosion of trust in GPs | 2012- | ||||
Poorer co-ordination between health providers | Patients with chronic or complex conditions | ||||
Increase in paying for treatment for those who can afford it, to the neglect of NHS patients | |||||
Distortion of service provision to take account of commercial opportunities | |||||
Closure of smaller hospitals and facilities – concentration into bigger centres | Staff in suburban areas | 2011- | |||
Small inefficient and dangerous providers kept in business by politicians at election time | Patients in suburban and rural areas | 2015 | |||
Small, especially voluntary, organisations replaced with bigger organisations with better tendering skills and an orientation on profit | BME and other minority groups | 2013- | |||
Destabilisation of hospitals in a chaotic fashion as a result of unco-ordinated commissioning decisions | |||||
Increase in transaction costs as a result of more providers | |||||
Decision making in commissioning more risky, because too small | |||||
Decision making in commissioning more remote because bigger | |||||
Lack of co-terminosity | |||||
Geographical inequity – postcode lottery | |||||
Erosion of terms and conditions of employment, especially pensions | NHS staff | 2010- | |||
Continuing boundary wars with social care, exacerbated by more mobile patients | |||||
Lack of geographical focus for commissioning because of patient choice of GP | 2012 | ||||
Even poorer deal for unregistered patients | Homeless, and mobile people, especially migrants and younger people. | 2012 | |||
Lack of strategic direction or planning | |||||
Reduced capacity to respond to crises as management capacity is reduced | 2011- | ||||
Distortion of clinical priorities in order to exploit commercial opportunities | |||||
Neglect of services without measurable outcome – mental health, terminal illness | |||||
Gps blamed for lack of everything | 2013- | ||||
Failure of commissioning consortia | 2014- | ||||
Conflict between GPs | 2012- | ||||
Concentration on short term outcomes to the exclusion of long term issues like health inequality | |||||
No attempt to address poor standards of primary care | |||||
Refusal of GPs or Foundation Trusts to compete on commercial terms | |||||
Provider led services | |||||
Consumer led services | |||||
Undermining NICE by means of the Cancer Drugs fund | All patients who don't have cancer | 2011- | |||
Undermining NICE generally | All patients who are not articulate or well connected |
page revision: 13, last edited: 05 Nov 2010 20:57
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