Abstract
BackgroundIn the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their ‘soft’ approach. In politics, concerns were expressed about public confidence. It was claimed that there are discrepancies between public opinions related to values and the values guiding regulation policies. Although the general public are final clients of regulators’ work, their opinion has only been discussed in research to a limited extent.The aim of this study is to explore possible discrepancies between public values and opinions and current healthcare quality regulation policies.MethodsA questionnaire was submitted to 1500 members of the Dutch Healthcare Consumer Panel. Questions were developed around central ideas underlying healthcare quality regulation policies.ResultsThe response rate was 58.3 %. The regulator was seen as being more responsible for quality of care than care providers. Patients were rated as having the least responsibility. Similar patterns were observed for the food service industry and the education sector. Complaints by patients’ associations were seen as an important source of information for quality regulation, while fewer respondents trusted information delivered by care providers. However, respondents supported the regulator’s imposition of lighter measures firstly.ConclusionsThere are discrepancies and similarities between public opinion and regulation policies. The discrepancies correspond to fundamental concepts; decentralisation of responsibilities is not what the public wants. There is little confidence in the regulator’s use of information obtained by care providers’ internal monitoring, while a larger role is seen for complaints of patient organisations. This discrepancy seems not to exist regarding the regulator’s approach of imposing measures. A gradual, and often soft approach, is favoured by the majority of the public in spite of the criticism that is voiced in the media regarding this approach. Our study contributes to the limited knowledge of public opinion on government regulation policies. This knowledge is needed in order to effectively assess different approaches to involve the public in regulation policies.
Highlights
In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their ‘soft’ approach
The criticisms expressed in the media, by politicians and by patient organisations are often directed at the regulators’ cooperating
This study shows that the majority of the public partly support this idea: the public assigned a high degree of responsibility to care providers
Summary
In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their ‘soft’ approach. The main research question in this study is whether there are discrepancies between the values and opinions of the public and the current values of policies and strategies for regulation of healthcare quality, and if so, what are these discrepancies? Regulation is often defined as “sustained and focused control exercised by a public agency over activities that are valued by a community” [32, 33], research shows that in risk cases involving for instance genetically modified food or radioactive waste, the public does not regard the government regulator as having the same values as themselves [34]. Differences between the values and opinions of the public and the current values of policies and strategies for regulation and underlying ideas of the theory of ‘responsive regulation’, are the main focus of this article
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