Responding to the Government’s consultation on licensing, we outline our concerns around the weight placed on sector regulation licensing relative to developing and improving quality regulation.
Through the instrument of the licence, the Health and Social Care Act 2012 allows Monitor to enforce rules, such as providing good quality data on pricing, prohibiting anti-competitive behaviour, and supporting patient choice, continuity of service and integrated care, as appropriate.
It is important that the regulatory functions of Monitor are balanced with the approaches and functions of other regulators and relevant organisations.
While Monitor and parallel organisations are still establishing themselves, economic regulation is likely to be underpowered, because the staff, information, guidance and monitoring systems are not yet in place
The new regulatory world created by the 2012 Act envisages a mixture of approaches from different bodies, including the Care Quality Commission, the NHS Commissioning Board and Monitor. It is not yet clear which approach will be dominant.
In the short run, while Monitor (and parallel organisations) are still establishing themselves, sector (i.e. economic) regulation is likely to be underpowered, because the staff, information, guidance and monitoring systems are not yet in place and may take years to mature.
This embryonic state should not obscure the future trajectory of economic regulation, which could potentially be very powerful and will interact with other system reform levers – particularly quality regulation, commissioning and design of payment currencies by the NHS Commissioning Board – in ways which are not yet clear.
Nuffield Trust (2012) Protecting and promoting patients' interests – licensing. Briefing.