COMMENT
Healthcare regulation must be statutory, not stationary
It is hardly earth shattering to suggest that the NHS is facing significant challenges and that even in straightened financial circumstances the demands on the health service will only continue to grow, says Anne Burge
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Anne Burge is the chair of the Registration Council of Clinical Physiologists
ow these economic pressures should be met has been the subject of
much debate, but it is clear that maintaining and building on existing standards of care, and meeting the needs of patients, will rely as much – if not more – on the continued professionalism and development of practitioners as it will on how services within the NHS are delivered.
This will require robust frameworks to ensure, develop and where necessary enforce standards through the regulation of individual disciplines, particularly as new practices evolve to meet the ever changing needs of patients and the NHS.
Regulation and oversight are nothing new to British healthcare. When the General Medical Council was established in 1858, its purpose was the registration of physicians and control over their working practices.
More than 150 years on, the GMC is still going strong and has been joined by an array of advisory and regulatory bodies across the multitude of disciplines that make up the modern day NHS. This includes the Health Professions Council, which is not limited to single discipline but rather imposes a regulatory framework on a variety of professional groups.
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Such development has made regulation central to healthcare delivery – and a crucial part of ongoing high standards when interacting with and treating patients.
In modern healthcare, it would be inconceivable to a member of the public that their GP or AHP would not be regulated or at least subject to extensive oversight. Such is the role of regulation within the healthcare sector that it is has become almost something of a safety net for patients – with a psychological benefit that encourages patient reassurance, in addition to maintaining standards of patient safety.
Such oversight is, therefore, one of the few things likely to remain a constant as the health service evolves to meet the challenges posed by society and particularly by the economic climate. This means not only that the reach and effectiveness of regulation must be maximised in order to ensure the maintenance of existing standards, but that any deficiencies in regulatory provision must be urgently addressed.
There are certainly fields that would benefit from additional oversight and one of these is clinical physiology, encompassing the disciplines of audiology, cardiology, gastro-intestinal physiology, neurophysiology, and respiratory physiology.
Clinical physiology is currently ‘overseen’ by the Registration Council of Clinical Physiologists (RCCP), a voluntary organisation that maintains a register of practitioners – providing a hub for the setting and maintenance of national standards, and some measure of regulation. Such a voluntary system does, however, have obvious drawbacks.
There is no requirement for practitioners to join; the organisation has no powers to veto the employment of any practitioner based on past performance or non- adherence to best practice; it has no statutorily enforceable disciplinary powers; and it is virtually unknown to the patients it serves – making lodging a complaint about an individual practitioner difficult at best.
This means it is currently possible for a practitioner to endanger patients then simply move to a new location and start over – with minimal restrictions or oversight.
Given a choice, statutory regulation would make considerably more sense than such voluntary efforts with enforceable disciplinary powers acting as the stick to carrot of the learning and development opportunities that such a body would also provide – and which has already been demonstrated by the GMC and HPC.
This, however, is sadly not as simple as it first appears. The establishment of statutory regulation can be a lengthy bureaucratic process leading to long delays (and hence extended
Jul/Aug 10
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