In 2003 the government recognised that a degree of co-ordination and oversight of the main healthcare regulators was needed and so it established the Council for Regulation of Healthcare Professionals (CHRP), which was subsequently renamed the Council for Healthcare Regulatory Excellence (CHRE). This was to be an entirely appointed Council of 19 members – 10 lay plus a representative from each of the 9 constituent health regulators.
The Council’s authority covers the General Chiropractic, Dental, Medical, Optical and Osteopathic Councils; the Health Professions Council and Nursing and Midwifery Council; and also the Pharmaceutical Society of Northern Ireland and Royal Pharmaceutical Society of Great Britain.
Between them, these regulators have nearly 2 million registrants of which, surprisingly, over half work outside the NHS.
But why stop there? What is so different about the CHRE’s constituent health regulators? Well, they each concentrate on certain and distinct bits of the body or do certain and distinct things to the body. Either way, they are all going to work on the same body where one would expect the same rules of professionalism, ethics and public safety to equally apply.
The fact that the healthcare system is split into these special interest groups is merely a
function of their origins – invariably from groups of public spirited and likeminded individuals who, long ago, valued the good name of their chosen profession and made rules to protect it.
The question, therefore, needs to be asked, which functions of a healthcare regulator are so
exclusive they are confined to a particular healthcare profession?
Some will answer this question by referring to the specialised training different health professionals undertake. However, a more detached view may only see a human body with its common anatomical and physiological features to which a range of techniques is applied. The nitty gritty of tailoring the science and skill to the individual professional group can be left to experts in the field but could a more arbitrary grouping oversee or police the rigour of the educational process itself?
Similarly, the ethical standards and principles that guide how a healthcare professional behaves are unlikely to vary from one group to another and a simpler, more consistent generic approach could be beneficial. Can you picture a UK generic health regulator as something like the DVLA but with no personalised number plates to flog? Now that’s a thought – why not sell personalised registration numbers?
But are there any benefits from healthcare professionals clinging to their own regulatory subgroup other than for reasons of sentiment or history? Professional morale is one reason. Whilst the intensified identity that comes from feeling part of a family of professionals could engender a degree of protectionism, there may also be a sense of pride, of self-motivation and of true vocation which can spur the carer to travel that extra mile to help the needy – and surely that is a benefit for all society. Or have we moved too far down the road of cynical commercialism even to imagine such a thing?
The healthcare regulatory industry, even at a time of economic uncertainty and austerity, is booming. Just take the GDC as an example – its staffing levels and budget have rocketed during the last couple of years. It is rolling out its plan to open devolved offices and as well as expanding to other premises in London’s West End, it is now thinking of increasing the size of its Wimpole Street building by further development of the site. You could say that all this is paid for by registrants and so long as we are all happy to fund it – that’s alright. But, ultimately, it’s patients who pick up the tab for their own protection and I wonder has anyone asked them what they think? For that matter has anyone asked you what you think?