NMC accountability may change?

[Guest guest]

Snipped from the HSJ:

Health regulators face legal overhaul

1 March, 2012 | By Steve Ford

Provisional plans have been drawn up that would give the Nursing and

Midwifery Council and other professional regulators increased

flexibility to use their powers while also making them more

accountable.

The law commissions of England and Wales, Scotland and Northern

Ireland said the different regulators currently operated within a

wide variety of legal frameworks, which had led to a " great deal of

inconsistency in their powers, duties and responsibilities " .

They have been asked by ministers to look at how the regulation of

health and social care professionals across the UK can be made

" clearer, simpler, more modern and more consistent " .

The law commissions published proposals today setting out plans for a

new single legal framework covering the nine professional regulators

across the UK.

Under the proposals, the regulators would be given " greater autonomy

to adopt their own approach to regulation in light of their

circumstances and resources " . However, they would be required to hold

a consultation whenever " issuing or varying anything which is

binding, anything which sets a benchmark or standard, and a

competency " .

In addition, it has been proposed that there would be a duty on each

regulator to provide information to the public and registrants about

its work.

Meanwhile, the government would be given " default powers " to

intervene where a regulator has failed or is likely to fail to

perform any of its functions. It would also be given the power to

abolish or merge any of the existing regulators, or to establish a

new regulatory body.

This would replace the current position in which the NMC, General

Medical Council and other regulators are accountable to the Privy

Council rather than a government department.

A consultation on the commission´s proposals will close on 31 May.

An NMC spokeswoman said: " The NMC will be responding to the

consultation and we encourage all nurses and midwives to contribute.

Our response will be published on our website in due course. "

The Commissions' paper is at

http://www.scotlawcom.gov.uk/consultations/

I was intrigued by the statement in this paragraph:

'3.32 Some regulators are required, when exercising their principal

functions, to:

(1) have proper regard for the interests of service users and any

differing interests of different categories of registrants; '

In relation to this, the consultation says:

'3.39 Some regulators are also required to have proper regard to

certain matters when undertaking their general functions, such as the

differing interests of different groups of registrants. This appears

to be an attempt to establish guiding principles for decision-making

by the regulators, which has been a successful innovation used in

other jurisdictions*. The difficulty is that the matters listed are

selective and do not provide a comprehensive guide for decision-

making. For example, there is no mention of the need to consider the

interests of the wider public or ensure that the functions are

carried out efficiently and expeditiously. We are attracted by the

idea of establishing general principles for decision-making and

welcome further views on what these principles might consist of.'

*The examples used are the Children Act 1989 and Mental Capacity Act

2005.

I'm not sure how one would frame 'general principles which would

underpin decision making' like this. There are some further

interesting bits on specialist registers, from which I quote these

bits:

'5.5 The public may see the purpose of registration as giving a stamp

of approval to an individual as a professional. This may be

particularly significant where the profession is largely self-

employed, registration is voluntary, a significant number of

practitioners are unregulated or the professional works from home or

some other non-official environment. For members of the public

seeking professional support, registers can play a useful role in

providing additional information to inform their choice. However, the

information on registers alone would not be sufficient to help them

choose one professional over another as it does not indicate who

would offer the best service. Notwithstanding the limits of registers

in this respect, most regulators maintain lists of specialist

practitioners or include in each individual entry educational

qualifications above the standard required for qualification. These

lists and entries may help guide public choice and inter-professional

referrals, although they may be less relevant where registrants are

employed predominantly in the public sector.'

'Provisional view

Specialist lists

5.26 It would be possible to give the regulators broad powers to

divide their registers into different parts and establish specialist

lists. Arguably, the regulators are best placed to know which

specialisms may be useful for potential users of the register and

whether particular specialisms are sufficiently differently from the

ordinary to make it necessary or desirable to create a specialist

register.

5.27 On the other hand, there are concerns that specialist lists

could be used to advance careers in the profession rather than as a

mechanism to enhance public protection, and that there are other ways

in which for example specialisms can be advertised such as by the

relevant professional bodies and employers. On this basis it might be

more appropriate for such decisions to be a matter for Government.

5.28 It is also important to consider that the existence of

specialist lists and different parts of the registers is referred to

in other legislation. For example, the Performers List Process

requires an NHS authority or board to satisfy itself that a General

Practitioner is a suitable person to be delivering NHS services by

requiring them to provide a range of information including a

declaration that they are on the General Medical Council´s specialist

register. Therefore, if regulators were given powers to alter or

remove specialist lists this could have consequential implications

for other legislation which would need to be amended. This may

reinforce the view that such decisions should be a matter for

Government.'

It goes on to state:

'5.29 On balance we think that the regulators should not be given

powers to establish specialist lists. Instead, we propose that the

statute itself should specify which types of registers should be

established by the regulators, including any different parts and

specialist lists. Our assumption is that the existing types of

registers would be maintained in the new statute. The Government

would then have powers to make regulations to create or remove

specialist lists or alter the existing parts of registers.'

The Consultation question states:

Provisional Proposal 5-3: The statute should specify which registers

must be established by the regulators, including any different parts

and specialist lists. The Government would be given a regulation-

making power to add, remove or alter the parts of the register and

specialist lists.'

Well, so much for self regulation....There are other interesting

points on student registration and volunrtary registers for

paraprofessionals & assistants, but the detail is a bit bulky for an

email. It's a big document and covers a lot of issues, not least

education amd fitness to practice.

H