"[the government's] approach carries significant risks. Competition and patient choice are both currently weak, and it is not known how much of either is needed to encourage providers towards better performance."and that
"PCT commissioning is also weak and GP commissioning consortia are likely to take several years to develop adequate skills for the job."This is damning, they are saying that these plans are not based on good foundations. Further they report:
"The reforms are substantial and will require significant management expertise to implement smoothly. They will occur at the same time as the NHS faces financial challenge, management capacity is being slashed and arms-length bodies are merged or abolished. A real concern is whether this level of reform can be implemented without risk of major failure."Finally this statement is significant:
"The move to outcome targets rather than process targets is welcome. But given that waiting for care is such a key part of patient experience on which the NHS is judged by the public, and the miserable history of long waiting times in the NHS in the past, waiting times should remain firm targets."Lengthening waiting lists is a key policy of Lansley's to move people over to private care or to persuade people to contribute co-pay. There is a proverbial cat in hell's chance of Lansley ever agreeing to reinstating the 18 week referral to treatment target even though this target is extremely popular with patients.