The Care Quality Commission should take on responsibility for “corporate governance” and “financial competence” alongside quality, Robert Francis QC has recommended.
The proposals for a single quality regulator, set out in the three volume Report of the Mid Staffordshire Foundation Trust Public Inquiry, call for Monitor to be merged into the CQC, LGC’s sister magazine Health Service Journal reports.
Mr Francis warns ministers to “avoid the temptation” of abolishing both regulators and starting again.
He writes: “A merger of the system regulatory functions between Monitor and the CQC should be undertaken incrementally and after thorough planning. Such a move should not be used as a justification for reduction of resources… it would be vital to retain the corporate memory of both organisations.”
The recommendation follows evidence to the inquiry that the CQC’s predecessor the Healthcare Commission and Monitor had not worked well together. This led to the trust becoming authorised as a foundation trust despite the Healthcare Commission having serious concerns.
Mr Francis has also recommended the CQC be given more powers to bring criminal prosecutions. Concluding that the Health and Safety Executive is “clearly not the right organisation to be focusing on healthcare”, Mr Francis calls for the CQC to be given comparable legal powers to bring prosecutions.
He also recommends providers should be criminally liable for a “breach of fundamental standards”.
However, CQC chair David Prior told HSJ his initial response was that it would not be good for the CQC to go through any formal merger with Monitor. He also said the objectives of Mr Francis’ recommendation could be achieved through closer working.
He said: “We can probably achieve what Robert Francis wants us to achieve without a formal merger with Monitor… The history of the CQC is of three mergers that happened six years ago and the ramifications are still being felt. To go through another merger now might be an unnecessary distraction.”
The health secretary also told HSJ that Monitor would continue as an economic regulator, and would probably run the “single failure regime” for providers announced by the prime minister in Parliament today.