The role of the market is ‘hugely limited’ in health and social care partly because its users often ‘have no power’, the Care Quality Commission chair has said.

David Prior made the argument at the Homelessness, Social Exclusion and Health Inequalities 2015 conference in London yesterday.

David Prior North Norfolk Trust chair CQC preferred candidate

David Prior said the CQC’s regulation had to be a driver of change in the NHS

He said: “In the NHS in particular the normal drivers of improvement that you’d see in the business world [such as] globalisation, consumer choice and competition… those things that drive change in many business areas, are simply not there.

“I’m a Conservative, there’s no secret about that, but the role of the market is hugely limited in health and social care, in part because many of the people who need care the most – as many homeless people are – are often unheard; they have no power.

“The market requires people with power, people who can choose [in order to bring improvement]. In healthcare that’s not the case.”

Mr Prior, a former Conservative MP and chief executive of the party, said this meant there was a need for the CQC’s regulation to be a driver of change in the NHS, as well as clinicians, providers and commissioners. He said “consumers” had an impact “to some extent”.

He also told the event, organised by homeless health organisation Pathway and the Faculty for Homeless and Inclusion Health, that he acknowledged the risk of the CQC inhibiting risk taking and service change, but that this was not intended.

“Some regulators get in the way – they do make change more difficult – and we’ve got to always be alive to the fact that we’ve got to be a catalyst for change,” he said.

Mr Prior also said the CQC must focus on “culture not compliance”, citing the underrepresentation of black and minority ethnic people in NHS senior leadership, including at the CQC and other arms’ length bodies.

Meanwhile, Public Health England director of health and wellbeing Professor Kevin Fenton, who also spoke at the event yesterday, was asked when it had challenged the government on issues of health inequalities affecting homeless people.

He cited PHE’s pressing the evidence in favour of tobacco product plain packaging, alcohol minimum unit pricing, and its Due North report, which it funded and which looked at some “economic drivers” and “broader determinants” of health inequalities in the north of England.

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