Holding public services to account is fine, but we need to do it efficiently

The suggestion that the role of the health service commissioner could be extended in order to offer an early warning system of what may turn out to be widespread clinical failures for other organisations makes a great deal of sense (see News, page 7). Clearly, someone should be doing it, and why not the commissioner? His office commands widespread trust, and through its dealings with substantial numbers of individual complainants is well placed to spot trends before they reach the point at which professional regulatory bodies usually step in.

But the commissioner is not alone in looking for a bigger and better job. Health ministers reportedly wish to see professional regulators take a more proactive approach to problem practitioners; the Commission for Health Improvement will offer a whole new dimension to the enforcement industry; the Audit Commission has grown beyond its original financial remit, to encompass issues of service management and even clinical quality; it, in turn, shares its probity and value-for-money home ground with the National Audit Office and its political masters on the Commons public accounts committee; and back on the individual patient complaints front, community health councils, too, would like greater recognition and resources.

There is greater demand now for regulation of both the public sector and the professions than there has ever been - not least from ministers keen to promise hit squads for those who fail to live up to expectations. And the watchdog industry's constituent parts have not been slow to offer themselves as the suppliers of solutions.

But there will come a time - sooner rather than later - when the regulatory and allied trades will need to be regulated more efficiently. Do we need this plethora of bodies, often overlapping, perhaps with gaps in their collective jurisdictions? Would it not be better for the public, as well as for those they seek to oversee, if there were fewer such bodies with more clearly defined remits? Hold the public services and those who work in them to account by all means - but at least do it in a way which is efficient, effective and easy to comprehend.