We have set out some reflections on governance in the public interest, drawing on our experience of our annual reviews, investigating specific areas of concern, and international work.
Background
In this paper the Authority sets out some reflections on governance in the public interest, drawing on its experience of its annual reviews, investigating specific areas of concern, and international work.
Over the past decade the governance of the health and care professional regulators in the UK has been transformed. The UK approach is no longer self-regulation but shared regulation; regulation shared by professions and the public in the interests of society as a whole. The councils or boards of the professional regulators are now much smaller, and have a balanced number of appointed professional and public members, rather than the large, elected, representative bodies of old. Presidents have become chairs and many are public rather than professional members. The focus of regulation on serving the public rather than the professions is manifest in these reforms, and is mirrored in similar developments in professional regulation in other sectors, such as the regulation of legal professionals.
Nevertheless, in the last few years instances of ineffective governance in some of the regulators we oversee have resulted in internal conflict and external loss of professional and public confidence. In the reviews that we have undertaken we have found examples of inappropriate personal and corporate behaviour which may have presented risks to the public interest and therefore warrant a wider reflection on what good governance looks like in a modern regulator.
Summary
In this paper we draw on our experience of annual reviews of the regulators’ performance; of investigating specific areas of concern such as our reports on the Nursing and Midwifery Council, the General Dental Council, and the General Social Care Council; and of developing policy in the sector to reflect on these issues. We also draw on our international experience, for example the review we conducted last year at the request of the Nursing Council of New Zealand which looked specifically at governance. We identify some common themes and concerns which we are aware others, notably the Committee on Standards in Public Life, have recognised too. We hope the regulators, the Departments of Health and those who hold other public office will wish to consider the reflections we offer in this paper.