CQC: Care Quality Commission or Can’t Quite Cope?

In this blog, I will discuss the need for change and a possible solution to the problems which are faced by the regulation of the health and social care industry in 2013.

The fact that the CQC is “not fit for purpose” seems finally to have begun to dawn on the government and Department of Health, following the publication of the Keogh report (which seems to have slipped into oblivion!) and the innumerable scandals in the NHS and independent social care sector over the last few months.

The attitude from the powers that be seems to be that by appointing a “Hospital Tsar” and a “Care Home Tsar” and telling the CQC to pull its finger out, all of the problems will be solved. I wonder, however, how long it will take before the government realises that what we have in healthcare is a situation akin to what was seen in the financial services industry and what we actually need is a very similar solution.

Those of us who have been around in health care regulation for a few years (10 years and over 1200 registrations in my case) have known for a long time that the regulator was unable to cope; due to a mixture of a lack of knowledge and understanding of the industry in both the top management and individual inspectors, policies which were naive to the point of stupidity and being hamstrung by inadequate powers to control a dynamic and rapidly changing industry.

Many of the issues which are arising in health and social care are a direct result of the failure of the primary legislation which underpins the Care Quality Commission rather than a failure of the organisation itself and the solution is probably a step-change in the way that health and social care is regulated.

We are all too familiar with some of the problems in the independent sector:

1. Medical treatments are classed as “not medical” and so not being CQC registerable
2. Treatments being carried out by untrained and unqualified people
3. Use of substandard or unregulated products for treatments
4. Providers offering medical treatments without registration or supervision but with apparent impunity.
5. Sale of products as medical devices which contain prescription medicines
6. Lack of training, qualification or supervision of staff
7. Failure to follow-up or support patients
8. Neglect and mistreatment of patients
9. Inadequate record-keeping and consent procedures
10. And the list goes on...

The fundamental problem here is that we need to take a leaf out of the book (or maybe even the whole book) of the financial industry in its attempts to “clean up” its act. It is incongruous (if understandable) that our money is now more tightly controlled and better regulated than the providers of our health and care services. Is it not now time for us to seize the opportunity and make the necessary changes to ensure that patients receive the best possible and safest standard of care in our health and social care establishments whether in the NHS or the private sector?