The I in the new CHAI

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7369.848 (Published 19 October 2002) Cite this as: BMJ 2002;325:848

New regulatory hybrid may send contradictory messages to health professionals

  1. Steve Dewar, director of health policy. (sdewar@kehf.org.uk),
  2. Belinda Finlayson, research officer.
  1. Health Policy, King's Fund, London WIG OAN

    The Secretary of State for Health of the United Kingdom has issued a rallying call to “unleash the spirit of public sector enterprise.”1 The problem, however, is that the current regulatory environment tends to reinforce a culture of compliance rather than enterprise. This risks a vicious cycle in which trust is undermined through an overbearing approach to accountability.2 This month the Commission for Health Improvement (CHI) published its corporate strategy for itself and its transformation into a new super-regulator of health care.3 But behind the fine words of the strategy lie major obstacles.

    The NHS Reform and Health Care Professions Act 2002 expanded the remit of the commission and gave it more “teeth.”4It requires the commission to publish information on performance and a revised star ratings system (from next year). It also gives the commission new powers to recommend franchised management, suspension, or closure of any service found wanting. In April 2002, the government announced plans for a new Commission for Healthcare Audit and Inspection (CHAI) to subsume the existing Commission for Health Improvement and incorporate the audit commission's value for money studies in health and responsibilities for inspecting and licensing private health care.3 The new commission is likely to take shape …

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