Should NHS managers be regulated?
NHS managers should be subject to professional regulation in the same way that doctors are – according to Sir Robert Francis QC – who led the public inquiry into failings at Mid Staffordshire NHS Foundation Trust. Speaking at a packed conference on litigation against doctors at the Royal Society of Medicine organised recently by the Urology Section, Robert Francis said that he thought doctors and managers should be on a “level playing field” in terms of regulation.
Sir Robert’s 2013 report on the Mid Staffordshire NHS Foundation Trust catalogued the managerial failings that led to the deaths of hundreds of patients. In the report, he stopped short of calling for professional regulation of NHS managers. Instead, he said that only people who passed a “fit and proper person” test should be allowed to become board level executives of trusts and other providers of NHS services. The fit and proper persons requirement for directors came into force for NHS bodies in November 2014 and is overseen by the Care Quality Commission (CQC).
However, speaking at the conference last week, Sir Robert said that the test would not, on its own, be enough to regulate those working as managers in the health system. “I do believe that, if we are going to have regulation of healthcare professionals, those that manage the health service should be within that system,” he said. “The system that we currently have is unlikely to solve the problem or to put everyone on a level playing field.”
Sir Robert added that there had been some difficulties with the “fit and proper person” test. “When we look at what really goes on in a hospital, we have consultants and, alongside them, managers. Together they are meant to manage a service and yet one side is subject to a regulator, and could be in jeopardy for any decision that they make, whereas the other side is not.” As an example, the GMC struck off the medical directors from a Trust in the West Country for failings related to gynaecological misadventures; while similar censure could not be applied to the hospital managers .
What are your views? Do you agree that hospital managers, who now wield so much of the power in NHS Trusts, should be regulated in the a similar manner to that of doctors?