Responsive Regulation: Trust and Transparency
This book has traced the substantial shifts in health care governance in the regulation of both professionals and organizations in the early twenty-first century. Governments have cast aside their reluctance to regulate doctors and health services, have passed legislation, and have established state and quasi-state bodies who engage in regulatory strategies ranging from persuasion to coercion. Regulatory activities have increased dramatically in number and in scope, including external mechanisms such as mandatory public reporting, and internal mechanisms such as peer audit. Health care providers aim to build patient safety cultures, continually improve quality, and learn from adverse events. The amount of activity in the short space of a decade is very impressive. The intention is to ensure that health care is of a high standard and as safe as possible – which is good news for patients. The new regulatory frameworks being constructed stress trust and transparency as key principles. Health care depends upon trust in professionals and hospitals – but trustworthiness comes at a price: the price the state has set is insistence on external accountability and transparency in clinical performance.