Regulation Inside Government: Approach and lessons learned Punita Goodfellow, Better Regulation Executive, Cabinet Office, UK

Key Areas UK framework for public service delivery Executive agencies Regulation as a tool for controlling service delivery Improving and scrutinising the regulation of public service delivery

UK Framework for Public Service Delivery Ministry Level – Develop policy and have overall responsibility to parliament and the electorate for service delivery Executive Agencies – Focus on improving delivery Service providers – groups of hospitals, doctors surgeries.

UK Framework for Public Service Delivery Spending Review – Three yearly reviews of expenditure, which set firm and fixed three-year ministry expenditure limits Public Service Agreements - define what the public can expect to be delivered as a result of the expenditure Spending Reviews have targeted resources at the Government’s priorities, such as education, health, transport and criminal justice and have set ambitious targets for improvements in key public services. Political commitment to delivery is based on improving quality of service not whether the delivery agent is public or private sector.

Focus on Delivery Moving from this – To this -

Executive Agencies Before agencies the Civil Service was governed by a body of centrally created rules - a culture more focused on avoiding errors than improving results. Agencies embody key principles of delivering better services - such as looking outwards to users, focusing on the key tasks to be delivered and increased transparency and accountability Agencies became the principal model for service delivery, including: social benefit/payments provision, inspection functions and logistical, procurement and administrative support to hospitals, education, prisons and the military.

Regulators ‘Regulators’ is a general term used to describe Executive Agencies which audit, inspect, or accredit. Three types: An arm of Government – Drinking Water Inspectorate Independent within public sector – Healthcare Commission Non-Governmental regulators – professional institutions, self-appointed groups – UK Accreditation Forum, British Medical Association, Institute of Civil Engineers

Accountability of Regulators Ministry is responsible for policy development and has overall responsibility for the delivery of that policy. Regulator is an organisation that focuses on achieving delivery, by directly controlling how a service is delivered. Chief Executive is in charge of the day-to-day management of the agency. Chief Executive reports to the minister on specific targets that the minister has set.

Purpose of Regulation Government promotes regulation to achieve: Good health, safety and welfare Increased productivity Good environment Greater fairness and opportunity Good competitive market framework

NHS Structure Delivery is by semi-autonomous organisations – service providers – clusters of hospitals/GPs – Explain what Special Health Authorities are

NHS Model “Arm’s length bodies” (ALBs) are stand-alone national organisations sponsored by the Department of Health undertaking executive functions. The work they undertake ranges from back office administrative functions to complex ethical or clinical-related work. For example - paying dentists; countering fraud; blood collection and processing; improving the safety of care; reducing the number of mistakes that can prove fatal to patients, setting standards and ensuring that service delivery is focussed on the patient.

Quality and Performance Framework Treasury Public Service Agreements Ministry of Health Standards for Better Health Healthcare Commission Quality assessment against Standards National Health Service What I mean by independent – still public sector – introduce concept of lead regulator – focal point of all regulation in that sector. Private Healthcare

Quality and Performance Framework Public Service Agreements provide the performance framework for Ministry of Health Standards for Better Health is a framework that the Healthcare Commission use to assess and improve the quality of the NHS and private sector healthcare.

Pressure For Regulatory Reform Over the past decade high levels of business and public concern: Burden of unnecessary bureaucracy – “red tape” – too much paperwork, complicated procedures “Nanny” state – excessive state interference Inflexible rules, too complex, dissuade investment Positive focus on improved delivery, negative impact caused by having many different organisations.

For Example This report - can lead to this paperwork - And we want in every health organisation to see this

Burden of Inspection Too many inspections can be caused by having too many arms length bodies Healthcare Inspection Concordat developed to minimise burden of inspection Healthcare Commission is lead inspectorate Long term goal to rationaise and reduce the number of inspection

Principles of Good Regulation Better Regulation Executive – Independent advisory body to improve regulatory practice developed the five principles of better regulation. Proportionality Accountability Consistency Transparency Targeted

What is a Regulatory Impact Assessment (RIA)? A procedure to be used by policy officials during the development of a policy to assess the impact of implementation options in terms of costs, benefits and risks. For the public sector, Departments must undertake a Public Services Threshold Test and if the impact of the policy is over £5 million, the Department must undertake a RIA

Regulatory Impact Assessment (RIA) Full range of potential impacts –economic, social, environmental Clarify objectives Assess alternatives Consult wide range of stakeholders Determine which groups are affected Central Government development of controls and pressures to ensure cultural change that will minimise bureaucracy.

Administrative Burdens Measurement exercise involving business Application of the standard cost model Administrative burdens reduction plans Feasibility of measurement in the public sector Similarities and differences between the business model and the public sector Central Government development of controls and pressures to ensure cultural change that will minimise bureaucracy.

Simplification Plans Rolling programme of simplification plans from every government department Apply ‘one in one out’ principle (off setting measures Administrative burdens plan, targets? Draft plans published Central Government development of controls and pressures to ensure cultural change that will minimise bureaucracy.

Across Government Prime Minister’s commitment Cabinet Committees for Public Service Reform and Panel for Regulatory Accountability Departmental Better Regulation Units Units Better Regulation Commission (independent) Small Business Service (independent) Better Regulation Executive (BRE) - including the Public Sector Team and the Business Regulation Team, at the centre of Government Central Government development of controls and pressures to ensure cultural change that will minimise bureaucracy.

Useful Links Better Regulation Executive http://www.cabinetoffice.gov.uk/regulation/index.asp Better Regulation Commission http//www.brc.gov.uk RIA Guidance http://www.cabinetoffice.gov.uk/regulation/ria-guidance/intro.asp Central Government development of controls and pressures to ensure cultural change that will minimise bureaucracy.