'Single tribunal' could judge all health profession cases

The comments by Bill Moyes, the former executive chair of foundation trust regulator Monitor, follow the government’s surprise decision not to change laws in order to streamline professional regulation before next year’s general election.

Several professional regulators argue that this failure to legislate hampers their ability to make quick decisions and protect patients.

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Mr Moyes criticised the delay in an interview with HSJ but said it should give the Department of Health time to consider some “bigger questions” such as whether regulators’ investigation and prosecution functions should be separated from adjudication.

He said he found it “very, very strange” that at present one body acted as “both prosecutor and judge” in fitness to practice cases.

“You could ask a question, instead of having a single body doing everything for a single profession or group of professions, whether we shouldn’t have professional regulators who investigate and prosecute [for separate professions], and a single tribunal for all of healthcare that judges and decides,” he said.

Mr Moyes said there were “conflicts” between regulators’ different roles and separating them could give them better focus.

He pointed out that the General Medical Council, which which regulates doctors, had established an independent adjudication panel in 2012 called the Medical Practitioners Tribunal Service. Mr Moyes suggested this panel could be the “kernel of something that [also] covered other professions”.

His time at Monitor, from 2004-10, covered the authorisation of Mid Staffordshire Foundation Trust and the revelations about its major care failures. He was questioned at Robert Francis QC’s public inquiry in 2011.

Mr Moyes said he supported strengthened quality regulation and the greater willingness of politicians to criticise poor NHS care, which has come about since his time at Monitor.

However, he said he did not recall examples of things which, during that period, should have been brought to light more quickly.

He added: “Sitting in this seat now I would place much more weight than I did then on professional regulation.

“The willingness of professionals to blow the whistle, not necessarily in a camouflaged way, but to say quite openly ‘this area of our work is not fit for purpose, people are not doing the right thing’.

“For a long time there has been a culture of that being not quite the done thing in healthcare… That is what we saw in Mid Staffordshire [and] Winterbourne View. People must have known but there was not a willingness to make sure that was drawn to attention.”

He called for “much more knitting together between” system and professional regulators.