Healthcare regulators branded cumbersome, ineffective and expensive

By The Press Association6th August 2015News EnglandCare Standards, Inspection, Management, News England, Report

Healthcare regulators in the UK are largely ineffective and are costing around £600 million a year to run, according to a report from the Professional Standards Authority (PSA).

There are nine organisations that regulate health professionals and social workers in the UK, ranging from those with “enormous registers” of nearly 700,000 like the Nursing and Midwifery Council to the “relatively tiny” such as the General Chiropractic Council, which has 2,846 registrants.

The report said it is harder still to keep track of the total number of organisations involved in the regulation, inspection, audit and scrutiny of different aspects of health and social care services, from medical devices to health and safety in residential homes, which are “almost impossible for members of the public to navigate their way through”.

It said the regulatory framework for health and care is out of date, over-complicated and too expensive, and is rapidly becoming unfit for purpose. Devolution of health services within the UK has also added further complexity.

It pointed out that from the outset, organisations have complained that they are inspected and reported on too many times, by too many bodies all of whom require data in slightly different formats.

The report, Rethinking Regulation, warned that without reform, health and care systems in the UK cannot face up to future challenges including an ageing population, long-term conditions, the rising cost of health technologies and a global shortage of health and care workers.

“If regulation was going to improve care, it would have done it by now. So it’s time to improve regulation,” the report said.

It said that while the Care Quality Commission’s operational expenditure in 2014/2015 was £211 million, Wales, Scotland and Northern Ireland have their own regulators and inspectorates of health and care, and the most recent figures available online suggest a total annual expenditure of £89 million.

Meanwhile the cost of Monitor was £72 million last year, and the Commission for Healthcare Improvement’s budget was around £32 million while the most recent calculation of the annual operating cost of the regulators overseen by the PSA was £195 million in 2010/2011, meaning the current total annual operating costs of regulation are in the region of £600 million.

PSA chief executive Harry Cayton (pictured) said: “Piecemeal adjustments to health and care regulation have, over time, made the system cumbersome, ineffective and expensive. Every part of our health and care system is changing in order to meet future needs. If patients are to benefit, regulation must undergo radical change too.

“Regulation is asked to do too much – and to do things it should not do. We need to understand that we cannot regulate risk out of healthcare and to use regulation only where we have evidence that it actually works. Ironically, the regulations that are meant to protect patients and service users are distracting professionals from this very task.”

Mick Armstrong, British Dental Association chairman, said it was leading the call for action on “regulatory fiefdoms”, whose bosses often earn more than the Prime Minister.

The regulator which oversees his profession, the General Dental Council, came bottom of the league in an assessment of the performance of nine healthcare regulators published in June by the PSA.

He said it has also faced defeat in High Court judicial review proceedings and a recent House of Commons Health Committee hearing into its conduct.

“There are over a million regulated healthcare practitioners in Britain, serving tens of millions of patients,” he said.

“Political intransigence is letting antiquated laws remain standard practice. And it’s come at a cost, in time and money, and patients and practitioners deserve better.

“The people running these fiefdoms are enjoying power without responsibility, and it’s about time they put patients first.

“We need to see a clear focus on the fundamentals. That means protecting patients, building firm foundations, not succumbing to inexorable mission creep.

“Too many regulators have lost the confidence of their professions. Effective independent regulation requires trust, and rebuilding that will mean genuine engagement, not just lip service.”