Regulation: We ain't got no satisfaction?

Abstract

During his ride to work on the London underground earlier this summer, your correspondent was interested to spot a sentence in the editorial columns of a leading newspaper, which read ‘.… it is shocking that it took the inspectors so long to identify and document the problem …’ This sentiment had particular resonance for him in the context of the Future Hospital Journal ( FHJ ), in that a principal driver for the work of the Future Hospital Commission (FHC) emerged from the review of the Mid Staffordshire NHS Foundation Trust by Sir Robert Francis QC. There, the failure not only of inspectors and regulators, but also of clinicians (in the widest sense) and their leaders, managers and inspectors, to identify problems in that Trust, resulted in shocking patient neglect, and saw the NHS at its lowest ebb for decades. However, the sentence did not refer to Mid Staffordshire, but rather to the recent ‘Trojan horse’ episode in Birmingham: the allegations of infiltration of school governing bodies by those seeking to advance specific political and/or religious agendas. The immediate reaction of politicians was to propose that state schools should face unannounced spot inspections. Whether the threat of an inspection, announced or not, improves any public service in many ways underpins the special focus of this issue: regulation and the regulators. The inspection mantra has been applied to other public services, many of which seem to be increasingly under the cosh. Your editor had time to recall without difficulty …