Regulating Healthcare: A Prescription for Improvement?

Regulating Healthcare: A Prescription for Improvement?

Regulating Healthcare: A Prescription for Improvement?

Regulating Healthcare: A Prescription for Improvement?


Healthcare organizations in the UK and the USA face a growing tide of regulation, accreditation, inspection and external review, all aimed at improving their performance. In the US, over three decades of regulation by state and federal government, and by non-governmental agencies, has created a complex, costly and overlapping network of oversight arrangements for healthcare organizations. In the UK, regulation of the government-run National Health Service is central to current health policy, with the creation of a host of new national agencies and inspectorates tasked with overseeing the performance of NHS hospitals and other organizations.

But does regulation work? This book:
. explores the development and use of healthcare regulation in both countries, comparing and contrasting their experience and drawing on regulatory research in other industries and settings
. offers a structured approach to analysing what regulators do and how they work
. develops principles for effective regulation, aimed at maximising the benefits of regulatory interventions and minimising their costs

Regulating Healthcare is aimed at all with an interest or involvement in health policy and management, be they policy makers, healthcare managers or health professionals. It is particularly suitable for use on postgraduate health and health-related programmes.


Health services in many developed countries have come under critical scrutiny in recent years. In part, this is because of increasing expenditure, much of it funded from public sources, and the pressure this has put on governments seeking to control public spending. Also important has been the perception that resources allocated to health services are not always deployed optimally. Thus at a time when the scope for increasing expenditure is extremely limited, there is a need to search for ways of using existing budgets more efficiently. A further concern has been the desire to ensure access to health care of various groups on an equitable basis. In some countries this has been linked to a wish to enhance patient choice and to make service providers more responsive to patients as 'consumers'.

Underlying these specific concerns are several more fundamental developments that have a significant bearing on the performance of health services. Three are worth highlighting. First, there are demographic changes, including the ageing population and the decline in the proportion of the population of working age. These changes will both increase the demand for health care and, at the same time, limit the ability of health services to respond to this demand.

Second, advances in medical science will also give rise to new demands within the health services. These advances cover a range of possibilities, including innovations in surgery, drug therapy, screening and diagnosis. The pace of innovation is likely to quicken, with significant implications for the funding and provision of services.

Third, public expectations of health services are rising, as those who use services demand higher standards of care. In part, this is stimulated by developments within the health service, including the availability of new technology. More fundamentally, it stems from . . .

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