Gordon Brown wants the power to strike you off.
Pre-empting a carefully worded Department of Health consultation paper on raising the quality of senior managers, published in response to the Mid Staffordshire inquiry led by Robert Francis QC, Gordon Brown made clear to the Commons that he wants them to be regulated.
The Department of Health’s proposals on assuring the quality of managers are teetering on the brink of excessive bureaucracy
When faced with a public outcry ministers too often feel compelled to do something. Impractical, unwieldy plans are drawn up which owe more to the need for a soundbite than to common sense. The vetting and barring system established in the wake of the Soham murders is a striking example of this knee-jerk approach to policy development.
The Department of Health’s proposals on assuring the quality of managers are teetering on the brink of such excessive bureaucracy.
Three of the four recommendations from the working group set up by health secretary Andy Burnham are sensible and proportionate, building on existing structures; the fourth - regulation - could create a vast, costly and pointless superstructure to oversee a system which would fail.
The three proposals more likely to win support - or at least acceptance - are to use a framework of standards and ethics to clarify the standards patients and staff can expect; encourage employers to drive professional standards through their recruitment procedures; then use governance measures such as appraisal and development to keep leaders on track.
At a time when money is tight and the regulatory and bureaucratic burden on managers too great, any response to public concern about management competence needs to come with a large dollop of common sense. As long as these three ideas do not grow in their development, they could all be implemented quickly and effectively at modest cost.
Indeed, voluntary accreditation may well appeal to managers on the foothills of NHS greatness. The ability to demonstrate their commitment and talent through such a scheme could provide a crucial advantage over less diligent competitors at interview.
When it came to full-blooded regulation, the DH was at pains to stress in its report that there was no consensus on whether it should be pursued. HSJ’s conversations with a wide range of opinion formers suggest even this may be a generous interpretation of the reaction. We found widespread scepticism.
NHS North East chief executive Ian Dalton, who chaired the advisory group which wrote the report, was clear in an interview with HSJ that any move to regulation would require extensive debate.
Apart from the cost, just think of the problems and pointlessness of it all. Imagine top flight chief executives with years of achievement to their name being compelled to fill in some worthless assessment form; think of the ire of a medical director - already regulated - now having to answer to a second regulator. How much form filling would be required before a manager from local government or the private sector was allowed on board?
Effective recruitment and governance are all that are needed. Voluntary accreditation may be a useful addition. Yet another health regulator is unnecessary.
But at prime minister’s questions the same day the report was published, Gordon Brown had no such inhibitions. He made plain in reply to a question on Mid Staffordshire that he supported a recommendation that failing managers could be struck off.
No such recommendation has been made. Instead, the report simply says the National Leadership Council should consult widely on the benefits and costs of regulation, and make a recommendation to ministers later this year. If anything, the advisory group’s tone is sceptical.
The Department of Health needs to reassert its grip on this debate, before casual soundbites for the consumption of voters push the NHS towards a regulatory system that will waste time and money while doing nothing for patients.