Patient Safety First: Responsive Regulation in Health Care

Patient Safety First: Responsive Regulation in Health Care

Patient Safety First: Responsive Regulation in Health Care

Patient Safety First: Responsive Regulation in Health Care


More people die each year in hospital accidents than in car accidents. This is a much needed systematic analysis of current issues, challenges and outcomes surrounding safety in patient health care in Australia. Each year more people die in health care accidents than in road accidents. Increasingly complex medical treatments and overstretched health systems create more opportunities for things to go wrong, and they do. Patient safety is now a major regulatory issue around the world, and Australia has been at its leading edge. Self-regulation by professional and industry groups is now widely regarded as insufficient, and government is stepping in. In Patient Safety First eading experts survey the governance of clinical care. Framed within a theory of responsive regulation, core regulatory approaches to patient safety are analysed for their effectiveness, including information systems, corporate and public institution governance models, the design of safe systems, the role of medical boards, open disclosure and public inquiries. Patient Safety First includes chapters by Bruce Barraclough, John Braithwaite, Stephen Duckett and Ian Freckleton SC. It is essential reading for all medical and legal professionals working in patient safety as well as readers in public health, health policy and governance.


Judith Healy and Paul Dugdale

Regulating patient safety

Health care can be risky for patients. Public inquiries continue to reveal unsafe practices in busy modern hospitals, surveys report that around one in ten patients experiences ‘things that go wrong’— that is, they suffer an adverse event during their hospital stay—and more people die each year in health care accidents than in road accidents. Realisation is dawning that medical errors are common events. Large numbers of adverse events do not necessarily mean that doctors and nurses are making more errors than in the past, but rather that there are now more opportunities for things to go wrong. Technological advances have substantially expanded the reach of health care, and more people undergo medical and surgical treatments; however, greater opportunities for intervention also increase the potential for harm. the Hippocratic injunction, ‘first, do no harm’, thus has new relevance for modern medicine, and patients now are less reassured by the mantra ‘Trust me, I’m a doctor’.

Health care governance has been undergoing substantial change since the beginning of the twenty-first century. Many countries, including Australia, have set up new regulatory bodies and are strengthening both internal regulation (by the professions and health industry) and external regulation (by the state and the public) in order to ensure better and . . .

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