Fitness-to-practise law expert Marie Dancer explains what a potential merger of healthcare regulators could mean for nurses
The Department of Health recently announced a forthcoming consultation paper that discusses the merits of merging health regulators. The consultation will propose the option of all nine healthcare regulatory bodies merging.
While some doubt the effectiveness of a so-called ‘super-regulator’, another option, which serves as a middle-ground approach, would be to merge related regulators. For example, regulators such as the Nursing and Midwifery Council (NMC) and the General Medical Council (GMC) would merge into a core regulator, with a separate merger occurring between other regulators for more high-street facing professions, such as pharmacists and opticians.
The objectives of potential mergers are to increase the efficiency of the regulation process, reduce duplication, increase accessibility for the public, improve patient safety and resolve fitness-to-practise concerns more efficiently.
There are significant potential advantages of a merger between the NMC and GMC. These bodies are not funded by the public, but by their registrants through registration fees. In the long term,
a merger of the GMC and NMC should result in significant cost savings for registrants. However, the merger costs are likely to be significant and would require a financial investment. There is an important question to be asked – who would bear the cost?
A merger of the two regulators may also improve consistency of outcomes for NMC and GMC investigation hearings. It may become easier for a single regulator to identify fitness-to-practise trends and facilitate proactive management of fitness-to-practise issues, which may reduce risks for patients in the long term.
A key argument against a merger of the NMC and GMC is the risk of deskilling the panellists who make fitness-to-practise decisions. The NMC and GMC understand the specific professions that they regulate and the unique challenges they face. Losing this specialist knowledge may result in longer hearings, causing more inefficiency and increasing the costs for registrants facing these hearings. However, there is a significant synergy between doctors, nurses and midwives and the challenges that they face, which may minimise this problem.
The NMC has confirmed that it is open to working more closely and collaboratively with other regulators, including the GMC, because of their common goals. The GMC appears to have adopted a more cautious approach, stating that it wishes to wait until the proposals are published before commenting.
The objectives of a merger between the NMC and GMC are admirable. However, there is doubt whether a merger, which would be expensive, would genuinely achieve the stated objectives. Finance, as well as politics, are likely to be substantial obstacles. Serious consideration should be given to whether the issues with the GMC and NMC justify a merger, or whether there are more effective options.
