Healthcare Regulation – the Future

Dr Ambrose McLoughlin, Secretary General, Department of Health shared his vision for healthcare regulation with Irish healthcare regulators at a recent seminar, organised by McDowellPurcell in Dublin.

Dr McLoughlin emphasised his crucial belief of the need for regulators to develop a far closer working relationship with employers/service providers, both public and private, and the general public as a whole. In doing this, he emphasised that the work of the Commission on Patient Safety and Quality Assurance – “The Madden Report”, must be considered. During his presentation, the Secretary General stressed the dynamic nature, and the transition of the traditional and changing roles of the Irish healthcare regulator.

Traditional Regulator Role

Historically regulator activities centred on;
Maintenance of a register – those who met stated minimum standards.
Building a strong relationship with the registrant/practitioner.
Emphasis on the profession and professional bodies.
Focus on undergraduate education.
Fitness to Practice.
Limited cross sector /jurisdiction working.

New/Changing Regulator Role

The regulator of the future must respond and adjust to;
  • Public expectation - protection of the public / accountability to the public.
  • Lay majority on Boards – transparency and consumer voice.
  • Prioritising real Continuing Professional Development – raise standards/skills and conduct of health care professionals.
  • The need to develop mediation services – less reliance on FTP.
  • The need to interface with the employer on an on-going basis – public and private.
  • The need to urgently reduce the cost base.  (Continued.....)

New/Changing Regulator Role (Continued..)

  • The need to work together as an effective unitary force in order to deliver more meaningful and more effective regulation.
  • The need to work closely with regulators in other jurisdictions.
  • The European dimension.
Three key challenges for regulators generally were identified as;

1) Continuing Professional Education – For maintenance of professional standards regulators must work with employers both public and private in order to ascertain what it is that employers and service provider require of health professionals in terms of:

2) Fitness to Practice - Regulation is becoming increasingly expensive and FTP is a significant driver of costs in this regard. While each regulator currently operates a multi layered legal FTP framework which cannot be altered without the enactment of primary legislation, mediation services need to be developed in parallel with existing statutory processes.

3) Reducing the cost base - Although self funding, health regulators must strive to reduce their operating cost base if statutory regulation is to continue as a viable option. In today’s climate the public expectation is that all state regulators should operate a lean, efficient and effective service which should make a real difference in protecting the public.

Finally, Dr McLoughlin stated that healthcare regulators must firstly embrace the need for a change in culture and adopt a group approach to health regulation. The drivers for this are a combination of societal/client expectations, changed economic climate, the need for greater transparency and governance and the growing need to align the approach to training and education across the professions. And secondly healthcare regulators must build better relationships/interface with employers, the general public, trade unions/staff representative bodies and other jurisdictions – particularly Northern Ireland/UK.