A consultation on a new paper concerning the pros and cons of merging health regulators has been announced by the Department of Health. The consultation will consider proposals that could have far-reaching consequences, the biggest of which is the option to merge all nine existing healthcare regulators, forming one overarching body. Some have suggested, however, that this would not be a wise move.
A slightly less extreme option than a single ‘super-regulator’ is the merger of the General Medical Council (GMC) and the Nursing & Midwifery Council (NMC), with the smaller, ‘street-facing’ regulators merging into a separate body. These changes have been put forward as a way to increase the efficiency of the regulatory bodies, increase accessibility for the public and to deal with fitness to practise concerns more effectively.
There would be significant advantages to a GMC/NMC merger. At present, the two bodies are funded by registration fees, as opposed to public money. Looking to the long term, registrants could save a lot of money through a merger. This is counterbalanced by the up-front costs of such a move, which would undoubtedly require investment from somewhere.
Another possible advantage is an improvement in the consistency of fitness to practise rulings across the two professions. A single regulator would have more data with which to identify trends and therefore take proactive steps when it comes to improving fitness to practise. Such steps could have a significant positive impact on patient safety in the future, which should always be the goal of fitness to practise regulation.
However, there are cons to weigh alongside the pros. A significant drawback is the deskilling of panelists, who would no longer be guaranteed to understand the specific professions that they’re regulating. The result of this deskilling could be longer hearings, which would reduce the efficiency that merging the regulators may otherwise create. That said, there is significant overlap between the issues faced by doctors, nurses and midwives, so the deskilling may not be as acute as some fear.
At present, the NMC has confirmed that it is open to working more closely with the GMC to achieve common goals. The GMC, however, has declined to comment until the proposals have been published.
It cannot be denied that there are good reasons to desire a merger of the GMC and NMC. However, it is unclear that a merger would actually be able to achieve its objective of greater efficiency. Finance and politics are likely to be stumbling blocks in the path of any major change, so serious thought must be given to whether the benefits of such a change outweigh the difficulties. It may be that there are alternative options that should be explored first.