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
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