Quality & Regulation in the Private Sector

9 March 2000

Over the summer months the emphasis has been on quality and regulation issues for the independent sector. The Health Select committee report on regulation, to which we submitted evidence, was contemporaneous with a Government white paper and a good deal of activity around the formation of the National Institute for Clinical Excellence (NICE) and the commission of Health Improvement (CHI). In addition there were draft proposals on clinical governance and patient complaints procedures through the Private Practice Forum (PPF). All of these issues will have a substantial impact upon the whole of the independent sector.

Firstly there is the government consultation document published in June, 'Regulating Private and Voluntary Healthcare', which is linked very closely with the House of Commons Select Health Committee Report, 'The Regulation of Private and Other Independent Healthcare' published in July. In essence these documents are proposing that there should be an independent regulator appointed in the private sector rather than bringing regulation under the Health Service Commissioner. The argument for the distinction is dubious but the sensible proposal is that CHI and NICE should be the inspection and standards body for both the public and private sectors. Much emphasis is placed on the role of the Medical Advisory Committees for ensuring clinical governance and other proposals.

The LCA has in general welcomed these proposals. We would like to see an agreed form of of external evaluation of private hospitals rather than the present arrangements of different assessors. This will also stop the current trend of the insurers increasingly using their own dubious quality issues to recognise or de-list certain hospitals. We welcome clinical governance and several of the Trustees, in their separate roles as MAC Chairman in different London hospitals, have been working together and with management to produce governance guidelines. These will be publicised to all consultants in due course. The overriding principle behind this is to encourage the highest possible standards in a fair and non-threatening manner.

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