1. Sarah.devaney@manchester.ac.uk Margaret.R.Brazier@manchester.ac.uk

2.  ManReg: the Manchester Centre for Regulation and Governance ◦ Regulating Reputations  Centre for Social Ethics and Policy ◦ Role of the Criminal Law in Healthcare

3.  Effective regulation: regulators responsive to the culture and needs of their regulatees ◦ which regulators use reputation and how (and which regulators could resort to it but do not) ◦ which regulatees respond to it and why ◦ in what circumstances it is effective and why.  Credible, effective, legitimate regulators

4.  ‘sustained and focused attempt to alter the behaviour of others according to defined standards or purposes with the intention of producing a broadly identified outcome or outcomes’. Julia Black (2002)  ‘obligations imposed by public law designed to induce individuals and firms to outcomes which they would not voluntarily reach.’ Anthony Ogus (2009)

5.  Command and Control  Right touch etc  Traffic lights  Healthcare – nudging  Regulation that will influence the behaviour of healthcare providers to care for patients in as safe and effective a way as possible in compliance with Good Medical Practice.

6.  ‘an unhealthy and dangerous culture pervaded not only the Trust … but the system of oversight and regulation as a whole and at every level.’  Trust Board: ‘tolerance of poor standards and a disengagement from managerial and leadership responsibilities’  Regulation: achievement of national targets, financial balance and foundation trust status prioritised the above patient care - agencies, regulators and professional bodies failed to step in

7.  Distress, stress and worry  Compliance is ‘the right thing to do’  Pride in being part of the solicitors’ profession, and the role of regulation in upholding the standards of the profession  Fear of reputational damage and a denting of ‘professional pride’ of greater significance than risk of sanction (SRA 2011)

8.  Little evidence of the behavioural effects of regulatory activity and interventions on those regulated  Complex: ◦ Goals and incentives of doctors ◦ Habits and self-belief ◦ Reconciling personal judgement with guidelines ◦ Team working and human factors ◦ Morale, workload and resources ◦ Organisational culture (Scraggs et al 2012)

9.  Why is reputation not important? ◦ Markets (but commissioning)  Can it become more important?  Complexity inhibiting professionalism?

10.  Major outputs  D Griffiths and A Sanders Medicine Crime and Society (CUP, 2012)  M Brazier and S Ost Bioethics and Medicine in the Theatre of the Criminal Process (CUP, 2013)  A Alghrani, R Bennett and S Ost The Criminal Law and Bioethical Conflict (CUP, 2012)