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You can find the current article at its original source at http://www.guardian.co.uk/commentisfree/2013/jun/24/health-regulator-take-care-editorial
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| Health regulation: take care | Health regulation: take care |
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| After a short moment of clarity, when the good guys and the bad guys seemed to have been caught bang to rights, murk is descending once again over events at the Morecambe Bay health trust and the Care Quality Commission. Yesterday, the CQC came out fighting the biting criticism of last week's independent inquiry. What no one has done yet is to admit they got it wrong. So nothing has been done for public confidence in the quality of regulation in hospitals and care homes – and less than nothing for the quietly determined James Titcombe, who is still searching for a satisfactory explanation of why a hospital where his baby son Joshua died because of poor care was registered by the CQC without any demands for improvements being part of the deal. | After a short moment of clarity, when the good guys and the bad guys seemed to have been caught bang to rights, murk is descending once again over events at the Morecambe Bay health trust and the Care Quality Commission. Yesterday, the CQC came out fighting the biting criticism of last week's independent inquiry. What no one has done yet is to admit they got it wrong. So nothing has been done for public confidence in the quality of regulation in hospitals and care homes – and less than nothing for the quietly determined James Titcombe, who is still searching for a satisfactory explanation of why a hospital where his baby son Joshua died because of poor care was registered by the CQC without any demands for improvements being part of the deal. |
| Yesterday's CQC news was dominated by an entirely unapologetic Today programme interview with Jill Finney, the former deputy chief executive of the CQC. Sounding as if she was the victim, she denied last week's finding that she had been involved in suppressing a report critical of the organisation's inadequate inquiry into the maternity unit at Furness general hospital, where Joshua died. She insisted she had not been able to put her case, that the report had been delayed only so that it could be beefed up, to the inquiry team, and they had later refused to listen to requests that they rephrase their findings. It was left to Mr Titcombe to point out that this is only a tiny part of a much larger tapestry of regulatory failure. | |
| Regulation is a big, tough job. It depends on the regulator having enough clout to demand compliance – and the regulated playing by the rules. It is as hard in the private sector as it is in the public. Regulation of organisations where there are plenty of incentives not to play straight, such as banking – or, yes, the press – is that much harder. If the inspectors lack the time or the expertise to understand what's going on, then the whole exercise is doomed to fail. The CQC, the result of a reluctant merger of three separate commissions, was overstretched and underfunded from the start. Its first task was to register 40,000 different health and care operations. No surprise then that it more or less abandoned inspections altogether, then resumed them in a minimalist form that was all too easy to evade by organisations that lack the culture of openness and transparency which every inquiry identifies as part of the answer. | Regulation is a big, tough job. It depends on the regulator having enough clout to demand compliance – and the regulated playing by the rules. It is as hard in the private sector as it is in the public. Regulation of organisations where there are plenty of incentives not to play straight, such as banking – or, yes, the press – is that much harder. If the inspectors lack the time or the expertise to understand what's going on, then the whole exercise is doomed to fail. The CQC, the result of a reluctant merger of three separate commissions, was overstretched and underfunded from the start. Its first task was to register 40,000 different health and care operations. No surprise then that it more or less abandoned inspections altogether, then resumed them in a minimalist form that was all too easy to evade by organisations that lack the culture of openness and transparency which every inquiry identifies as part of the answer. |
| In effect, non-experts in health who answer to Whitehall are trying to regulate hospitals run by non-experts in medicine who answer to Whitehall. Managerialism has replaced professionalism. Until professionalism comes back – a pride in standards but also a willingness to admit mistakes – then looking after patients properly will go on looking like a secondary concern. | In effect, non-experts in health who answer to Whitehall are trying to regulate hospitals run by non-experts in medicine who answer to Whitehall. Managerialism has replaced professionalism. Until professionalism comes back – a pride in standards but also a willingness to admit mistakes – then looking after patients properly will go on looking like a secondary concern. |
| • This article was amended on 1 July 2013. An earlier version described Jill Finney as a former deputy chair of the CQC. She is a former deputy chief executive. |