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Feature Healthcare Regulation

The Care Quality Commission: unfit for purpose?

BMJ 2011; 343 doi: (Published 14 December 2011) Cite this as: BMJ 2011;343:d8034
  1. Nigel Hawkes, freelance journalist
  1. 1London, UK
  1. nigel.hawkes1{at}

The Care Quality Commission is under fire from all angles. Can things get better? They can hardly get worse, says Nigel Hawkes

Seldom has any NHS organisation suffered such an unrelieved run of critical comment as the Care Quality Commission, damned from all sides yet its chair and chief executive are still in post.

From the Health Select Committee to the National Audit Office by way of the public inquiry into Mid Staffordshire NHS Foundation Trust, the bad news keeps on coming. A member of the commission’s board, Kay Sheldon, has joined the chorus, accusing the commission’s chair, Jo Williams, of poor leadership and demanding the removal of the chief executive, Cynthia Bower.

Her allegations were swiftly denied, as were those of one of the commission’s inspectors, Amanda Pollard, who said it had “appalling” training standards and a bullying culture. But the Health Secretary, Andrew Lansley, has ordered a review into the allegations, to be carried out by Gill Rider, president of the Chartered Institute of Personnel and Development.

In its denials the commission is not playing from a position of strength. Its reputation was seriously damaged by its failure to follow up effectively on information from a whistleblower about Winterbourne View, a private hospital for people with learning disabilities in Bristol. It was left to the BBC’s Panorama to pursue a tip from the same source and expose bad care. To add insult to injury, the Sunday Times recently reported that Ms Bower—“one of the best-paid quango bosses in Britain”—received £435 000 (€510 000; $680 000) last year for presiding over this. (The figures, available in the CQC’s annual report, are made up of a salary of £195 000 and a pension uplift of £240 000.)

Can things get better? They can hardly get worse. Still, the commission can look on the bright side: …

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