Prime Minister Sir Keir Starmer has urged his Cabinet ministers to take greater accountability for decision-making, signaling a potential shift in how regulatory bodies operate within the UK government. During a Cabinet meeting on Tuesday, Starmer criticized the "outsourcing" of decisions to regulators and quangos—a practice he attributed to the previous administration—and emphasized the need for a "strong, agile, and active state" that directly delivers for working people.
This announcement comes ahead of a planned intervention on Thursday, where Starmer is expected to unveil proposals to overhaul the British state. Ministers have been tasked with reviewing whether existing regulations align with Labour’s "plan for change," raising concerns that rules deemed irrelevant to the government’s agenda could be abandoned. While Downing Street has refrained from specifying which regulators might be affected, speculation about a "bonfire of quangos" has intensified.
Implications for Healthcare Regulators
Healthcare regulators such as the General Medical Council (GMC), General Dental Council (GDC), and Health and Care Professions Council (HCPC) are now under scrutiny amidst this broader push for reform. These bodies play a critical role in maintaining professional standards and public safety through fitness-to-practise procedures. However, concerns about their effectiveness have persisted.
For instance, the HCPC has recently faced criticism from the Professional Standards Authority (PSA) for failing to meet four out of five standards of good regulation in its fitness-to-practise work. Issues cited include poor case management, inadequate investigations, and delays that risk undermining public confidence. Similarly, the GDC has been working to refine its approach to fitness-to-practise cases by improving efficiency and clarity around thresholds for professional misconduct.
These concerns have fueled calls for reform across healthcare regulators, particularly regarding their handling of fitness-to-practise cases. Critics argue that the current systems often lack transparency, fairness, and efficiency, leaving both practitioners and patients dissatisfied.
Could Healthcare Regulators Face Abolition?
Starmer's remarks have raised questions about whether healthcare regulators could be affected by the government’s drive to centralize decision-making. While no specific mention of healthcare regulators has been made, the broader critique of regulatory bodies suggests their powers could potentially be restructured or brought "in-house." This would mean transferring decision-making authority from these independent bodies to government departments or entities directly under ministerial control. In practical terms, it could involve absorbing the functions of regulators like the GDC, GMC, and HCPC into government structures, allowing ministers to exert more direct oversight and control over processes such as fitness-to-practise cases.
The prospect of abolishing or significantly reforming these bodies is contentious. On one hand, centralizing their functions within government departments could streamline processes and ensure alignment with national priorities. On the other hand, regulators are designed to operate independently to safeguard public trust and professional standards—a role that could be compromised if political interference increases.
Balancing Reform with Public Safety
As discussions about regulatory reform unfold, it is crucial that any changes prioritize fairness, efficiency, and public safety. Fitness-to-practise procedures are not merely administrative; they are fundamental to ensuring healthcare professionals remain capable of delivering safe and effective care. Missteps in reforming these systems could jeopardize patient safety and erode confidence in healthcare governance.
Healthcare professionals and stakeholders will undoubtedly watch closely as Starmer outlines his plans later this week. Whether these reforms will lead to a more dynamic state or disrupt vital regulatory functions remains an open question—one that demands careful consideration.
In light of ongoing concerns surrounding fitness-to-practise cases and calls for reform, the government's approach must strike a balance between accountability and preserving the independence necessary for effective regulation.
Sunil Abeyewickreme, Partner at the international law firm, Gunnercooke LLP, who represents healthcare practitioners in regulatory proceedings commented:
"With ongoing concerns about fitness to practise cases handled by regulators like GDC, GMC, and HCPC, and calls for reform, the PM's comments raise a critical question: Could healthcare regulators face abolition in the proposed 'bonfire of quangos'? Reform must prioritize fairness, efficiency, and public safety."