The Department of Health has announced a forthcoming consultation paper regarding the merits of merging health regulators. One option is the merger of all nine statutory healthcare regulators to form one ‘super-regulator’. However, some doubt the wisdom of merging all nine regulators at once.
A middle ground option would involve a merger between regulators such as the NMC and GMC to form a core regulator, with a separate merger between other regulators for more high street facing professions such as pharmacists and opticians.
The objectives of potential mergers are to increase efficiency of the regulation process, reduce duplication, increase accessibility for the public, improve patient safety and resolve fitness to practise concerns more effectively.
There are great potential advantages of a merger between the NMC and GMC. The GMC and the NMC 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 to execute. There is a significant question to be asked of who would bear the cost of this.
A merger of the two regulators may also improve consistency of outcomes for NMC and GMC fitness to practise hearings. It may make it easier for a single regulator to identify fitness to practise trends and therefore 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 GMC and NMC is the risk of deskilling the Panelists, who make fitness to practise decisions. The GMC and NMC 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, resulting in increased costs for registrants facing fitness to practise hearings.
However, there is a significant synergy between doctors, nurses and midwives and the challenges that they face, which may minimise whether Panelists will become deskilled.
The NMC have confirmed that they are open to working more closely and collaboratively with other regulators, including the GMC, due to their common goals. The GMC appear to have adopted a more cautious approach, stating that they wish to wait until the proposals are published before commenting.
The objectives of a merger between the NMC and GMC are admirable. However there is genuine doubt whether a merger, which would be expensive, would genuinely achieve the stated objectives. Finance as well as politics between the NMC and GMC are likely to be substantial obstacles to the creation of a merged regulator.
Serious consideration should be given to whether the current issues with the GMC and NMC justify a merger, or whether there are more effective alternative options which should first be explored.