Exclusive: Hunt says Monitor will survive and run 'failure regime'

Robert Francis today said the CQC should take on responsibility for oversight of finance, governance and authorising foundation trusts, taking on key roles from Monitor. It appeared to pave the way for Monitor’s potential abolition, or signficant scaling down.

However the health secretary told HSJ Monitor would continue as an economic regulator, and would probably run the “single failure regime” for providers announced by the prime minister in Parliament today.

Mr Hunt indicated the new regime would be a development of Monitor’s current compliance and licencing regime, as opposed to the special administration or insolvency regimes, which are more commonly known as the failure regime. The regime would be “something people can be put into because of poor quality care”.

He said all “all the economic regulator functions… will absolutely remain with Monitor”.

“When we talk about a single failure regime, Monitor will run that failure regime. We probably need to have a different organisation [the CQC] responsible for assessing and inspecting, to the organisation that is charged with sorting it out [taking action].

“Monitor is obviously the most likely body to be responsible for the failure regime.”

Asked whether the CQC’s future role would include inspection in relation to finance, Mr Hunt said that detail had yet to be decided.

Meanwhile, asked whether the job of NHS chief executive Sir David Nicholson was safe, Mr Hunt highlighted Mr Francis’ conclusions that “it would be a mistake to find a scapegoat or to say that we wouldn’t have had a problem if if we had had someone better doing the job”.

Mr Hunt said the DH hoped Don Berwick, the international patient safety leader and former advisor to Barack Obama, would report on how to apply the concept of “zero harm” in the NHS before the summer.

He said: “What we want is a zero harm approach. We want [Mr Berwick’s] advice as to how to do this.

“[But there are] a variety of types of harm which are completely avoidable. We want to make sure is hospitals have a zero harm approach to those types of harm.”