The Government has announced that they are going to publish a consultation paper regarding the merits of merging nine health regulators to form a new ‘super-regulator’.
This would involve combining the GPhC (pharmacists), the Pharmaceutical Society of Northern Ireland (PSNI), GMC (doctors), NMC (nurses and midwifes), GDC (dentists), HCPC (16 professions including paramedics and social workers), GOC (opticians), GCC, (chiropractors) and the GOsC, (osteopaths). Other suggestions may include grouping some of the regulators together and leaving others to remain alone.
The stated motivations behind the proposed ‘super-regulator’ are to make the regulation of health professionals more efficient, easier for the public to understand, improve patient safety and resolve fitness to practise concerns more quickly.
There are some clear advantages of a new super-regulator. It would be useful to have a common set of professional and ethical standards for all healthcare professionals. This could always be supplemented by profession specific standards, which is the model used by the HCPC.
One super-regulator would have one public register for all healthcare professionals, which would be more accessible for the public and employers.
The regulators are not funded by the public, but by members through registration fees. In the long term, a merger of the regulators should result in significant cost savings for members. However how much time it would take to see any cost savings remains unclear. The transition costs of a merger of all nine regulators would be enormous. There is a significant question to be asked of who would bear the cost of this.
A super-regulator may improve consistency of outcomes of fitness to practise hearings. It may also make it easier to identify trends to facilitate pro-active management of fitness to practise issues, which may reduce risks for patients.
However a super-regulator which is deliberately easier for the public to access, may increase patient led fitness to practise referrals. Patient complaints are often appropriately resolved through local intervention without the need for escalation to fitness to practise referrals. Increasing public access may well result in a rise in unnecessary fitness to practise referrals, which will increase cost and decrease efficiency.
Currently, the individual regulators understand the specific professions that they regulate and the unique challenges they face. Losing this specialist knowledge could potentially result in longer hearings, causing more inefficiency and extra costs for registrants.
Merging all nine regulators will be an administrative challenge, with very significant cash flow consequences. The initial cost, including redundancies etc. is likely to run into the millions.
The aims of a super-regulator may sound idealistic and the stated objectives admirable. However, there is genuine doubt whether a merger, which would be hugely expensive, would genuinely achieve the stated objectives. Finance as well as politics between regulators are likely to be substantial obstacles to the creation of a super-regulator. Serious consideration should be given to whether the current system is sufficiently badly broken to merit such intervention.
Marie Dancer is a specialist fitness to practise solicitor and managing partner at Richard Nelson LLP and the Medic Assistance Scheme.