REGULATION Inspector submits application calling for single body to 'survey whole landscape'

Published: 15/12/2005 Volume 115 No. 5986 Page 8

The Healthcare Commission this week set out its stall for a single regulator in health and social care with chief executive Anna Walker arguing financial and quality performance were 'inextricably linked'.

Ms Walker also warned the Department of Health it had to answer some 'crucial questions' about the future of the NHS before it drew up a new regulatory framework.

The commission argues in its submission to the government's review of regulation that the DoH should establish a single regulator to 'survey the whole landscape'.

It adds: 'In the delivery of healthcare, questions of money cannot be disentangled from questions of safety and quality.' The view is in direct conflict with that of foundation trust regulator Monitor, which is fighting to be a separate economic regulator.

But Ms Walker told HSJ questions of finance and quality were 'different sides of the same coin' and 'decoupling' them would lead to conflict between the two regulators.

'We believe [finance and quality] are inextricably linked and are concerned that if you disaggregate them you might find that people become absolutely fixated, as they have in the past week, in making the books balance without realising that has got a direct link to the quality of service.' The commission has warned the government, which is hoping to set up four public service regulators from 2008, that reforming regulation of health and social care is a 'major task'.

Streamlining healthcare regulation is 'a very significant venture' and doing it at the same time as 'extensive re-organisation in the health service' is described as 'at best ambitious'.

The submission also urges the government to sort out the 'blueprint' of health and social care reform before building the regulatory structure.

Ms Walker said: 'The government can ask itself some crucial questions at this point. What is their policy in opening the sector up to all players because that will tell you how much economic and competition regulation you need in the system.' The government also needs to decide whether it wants to continue to set standards and prices in the new regulation landscape, Ms Walker added.

'The government can answer those questions within the next few months, and once it has done that we will have a much clearer view of the regulatory functions.'