This month we ask: Is statutory regulation an effective mechanism for patient protection?
Neil Willis
Retired Senior Chief Biomedical Scientist
Medical Biochemistry, University Hospital of Wales
The Health Professions Council (HPC) was formed following an Order in Council approved by both houses of parliament and was “made” by the Privy Council on 1 April 2002, giving the HPC its statutory status for regulation with the principle aim of protecting the public by setting “Standards of Education” and “Standards of Conduct, Performance and Ethics”.
The HPC – now “Health and Care Professions Council” (HCPC) – has evolved Standards of Education and, along with the IBMS Certificate of Competence, endeavours to ensure registrants have the necessary education and skills to practise effectively and safely and continuing professional development is designed to keep registrants up to date.
University programmes are approved by the HCPC and accredited by the IBMS for UK registrants as an entry point into regulation, but overseas applicants without UK qualifications only have to prove that they have been practising safely for a minimum of three years, these applicants could potentially be a risk to patient safety.
In a perfect world, all biomedical scientists would adhere to the IBMS Code of Practice. But, in the imperfect world, the HCPC has fitness-to-practise panels for those whose practice falls below the required level.
The panels are made up of lay people and registrants from the respective professions and can impose sanctions. Is there a better way to protect the public?
Alan Kershaw
Independent member
Various professional bodies
Yes. And no. Effective regulation – lay-led to headline the patient focus, professionally-informed to ensure buy-in and earth the whole business in reality – is certainly central to the delivery of safe, competent healthcare.
Regulation is not something a regulator can “do” to a professional group. Effective regulation is a partnership between regulator, bodies representing the profession and patients, centres of excellence (education providers, royal colleges, institutes) all have their role to play. When all are singing the same songs, regulation works and standards are higher than would otherwise be the case. If they are at odds, the system is dysfunctional – standards are uncertain, professionals obey the rules with clenched teeth, patients are less well protected.
I have worked with statutory regulators and with professions where regulation is carried out by a professional body with a strong regulatory arm. Both can work effectively provided the partnership I mentioned above works harmoniously.
So does it add value to enshrine the regulatory system in law? The classical view, to which I subscribe, is that it depends on the degree of risk a professional group poses to the public: what are the worst consequences that could flow from unfitness to practise? Are those things that could be reversed, or adequately compensated? Is the public in danger from unregulated practitioners unless a professional title is protected? These are areas where statutory backing can ensure effectiveness.
Sally Gosling
Assistant Director of Practice &
Development
Chartered Society of Physiotherapy
Not all the issues raised by the regulatory reform consultation are new. There’s learning to build on about what’s effective and a need to ensure professional regulation protects the public in proportionate, sustainable ways. Promoting professionalism and compassionate care, managing risk, and reflecting flexible workforce deployment all are key – as is a more pre-emptive approach, so fewer fitness-to-practise cases arise.