JUDITH HEALY, Improving Health Care Safety and Quality Reluctant Regulators, Ashgate Publishing Ltd, 2011, 328 pp., £70, IBSN: 9780754676447 (hardback)
✍ Scribed by Aly Hulme
- Book ID
- 102254517
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 45 KB
- Volume
- 26
- Category
- Article
- ISSN
- 0749-6753
- DOI
- 10.1002/hpm.1115
No coin nor oath required. For personal study only.
✦ Synopsis
Over the last decade, globally, the issues of patient safety and quality of care have captured the attention of policy makers, healthcare professionals, managers and the public. This book reflects the author's extensive experience and understanding of analysing healthcare systems in many countries.
The book attempts to explore whether greater regulation has improved healthcare safety and quality. The book's title implies that the main theme is about 'reluctant regulators', but on review, this is not clearly reflected: rather, it offers accounts of the various systems and approaches of healthcare governance in different countries to improve safety and quality. It demonstrates the significant extent to which certain approaches to the governance and regulation of healthcare organisations and professions have been particularly influential and have sought to improve healthcare quality and safety. But in the end, the book does offer little judgement as to whether increased regulation has improved healthcare safety.
What the book does do clearly is to identify the regulatory mechanisms, the regulatory principles and the strategies implemented to improve governance in healthcare systems used in different countries. The author favours the theory of networked governance, which involves numerous regulators and various strategies working together to create regimes of responsive regulation. Although there has been a dramatic growth in regulatory mechanism, this expansion has occurred in a very disjointed way, with no coherent joined up overview between actors and agents. The book proposes a conceptual framework for 'responsive regulation'. This recognises that although healthcare professionals' main intention is to do the right thing, like all human beings, they are fallible, may get it wrong and may require support. Put simply, regulators should be 'responsive' to the situation in context and culture of those being regulated.
The book is not comprehensive, even in its coverage of healthcare systems, interests and sectors. There is a strong emphasis on developments in Australian healthcare regulation, with perspectives from the USA, the UK and from other European counties, but there is very little from any other countries-this is about the regulation of healthcare in the developed world. There is a strong emphasis on the medical profession rather than on other professions within healthcare; and acute hospitals dominate at the expense of mental health, learning disabilities, community services or general practice. Finally, the author raises important issues around private nursing homes and regulation, but only briefly and not in much detail.
Why do regulatory systems take the form they do? The connection between regulation and the wider context of political systems in some of the countries is