ABSTRACT
A responsive regulation perspective regards enforcement as one of many strategies that in terms of greater strength and lesser frequency of use is located at the apex of a regulatory pyramid. This chapter discusses stronger strategies for regulating the safety and quality of health care in relation to three broad mechanisms, such as laws, money, and monitoring. Legal instruments include legislation, regulations under an act, rules, directives, government endorsed standards, tort law, and contracts. A legal framework ranges upwards in strength from guidelines to laws in a hierarchy of mechanisms from soft to hard law. Soft law refers to quasi-legal instruments that do not have binding force, or whose binding force is less than in traditional law referred to as hard law. Health practitioner legislation dates from the nineteenth century when medical boards were established in each state, but the governance of the health professions now is being transformed.
