The coalition Government has moved swiftly since the election to announce proposals which will impact substantially on the regulatory landscapes of the health and social care professions.
Against the backdrop of the Government’s commitment to reducing the administrative costs of the NHS by 45 per cent, a July report proposed changes to the national network of the 18 Department of Health ’arm’s-length bodies’ (ALBs) that regulate the health system, to ensure those retained are fit for purpose and affordable.
As far as regulation is concerned, one major change is the announcement of the abolition of professional regulator the General Social Care Council (GSCC).
The report finds no compelling reason to retain the GSCC and recommends that social work regulation should be put on the same footing as that of the health professions. The GSCC will therefore be abolished by primary legislation, likely by April 2012. Social workers’ regulation will become self-funding through registrants’ fees and move to the Health Professions Council (HPC), which currently regulates 15 health-related professions.
Although assurances have been given that standards will not be watered down, there are concerns about how social work regulation will fit into the HPC’s health model. These are not abated by the absence of detailed proposals for implementation.
The future of the newly created Office of the Health Professions Adjudicator (OHPA) is also in the balance, following a government announcement at the time of the review. OHPA was established by the Health and Social Care Act 2008 in the wake of a series of reviews, including the fifth report of the Shipman inquiry. It advocates the separation of the function of adjudicating on medical disciplinary cases from that of investigation and prosecution.
It was due to take over the General Medical Council’s (GMC) adjudication function in 2011 and the General Optical Council’s in 2012, with other healthcare regulators likely to follow.
The Government now says it is not persuaded that the creation of another body is the most appropriate way forward, and believes that steps to strengthen the adjudication process within the GMC can deliver similar benefits.
OHPA’s draft response to the current consultation on its future argues that, whatever the short-term gains, in the longer term it will potentially deliver greater cost benefits by creating more efficient adjudication mechanisms and processes across healthcare regulators.
Crucially, the revised proposals are unlikely to deliver the visible guarantee of independence advocated by the Shipman inquiry report and the White Paper ’Trust, Assurance and Safety’.
In a separate, surprise development in June the Secretary of State for Education announced the abolition of the General Teaching Council for England (GTCE). Although not part of the ALB review, it represents another significant change of direction under the same broad initiative. As yet, there are no proposals for the future professional regulation of teachers after the removal of the GTCE in 2011.
The combined effect of these proposals is significant, leaving a question mark over the future of the regulation of two major public service professions and highlighting the lack of detailed proposals for the future.
There will be mixed opinions about the OHPA proposals. Some may take the view that the recent proposals (if pursued) at least halt, whether temporarily or not, the programme of regulatory reform which has been ongoing since the early 2000s.
It has to be remembered that the reforms had their origins in concerns following a number of high-profile scandals in the late 1990s and early 2000s.
Will revised proposals for healthcare disciplinary adjudication be adequate to re-establish confidence in regulation? The first step is the outcome of the consultation on OHPA’s future.
The current void as far as social workers and teachers are concerned cannot be conducive to maintaining public confidence.