Faced with the squeeze on public spending it seems no politician is willing to suggest cuts in frontline staff, so it's quangos and regulators that get their focus.
At The King's Fund debate at the Liberal Democrats' conference last night, Norman Lamb MP complained that there are 60 regulators inspecting hospitals, asking the same questions, duplicating work and creating a bureaucratic burden on NHS staff. As in his speech to conference delegates earlier in the day, he called for a reduction in the number of regulators and for simple, clear lines of accountability.
While there is a clear case for regulators to be better co-ordinated and reduce the burden on providers – by sharing and making better use of data for instance – they're perhaps an unfairly easy target for politicians. We would do well to remember that before the introduction of independent regulation the NHS did not have to account publicly for the quality of care – a situation no-one would suggest we return to today.
Making the cuts to existing regulators' budgets that Norman Lamb has suggested won't, on their own, be enough to fill the gap between projected future NHS budgets and the cost of future demands on NHS services. To survive the public spending squeeze ahead hard choices will have to be made throughout the NHS and, as 70-80 per cent of the health budget is managed and spent by local primary care trusts, it's hard to see how local frontline services can be exempt from cost-cutting measures.
And, as his fellow panellist Jackie Ashley cautioned, while a 'bonfire of the quangos' may play well to audiences at conference, regulators play an important role in protecting the public. Norman Lamb should remember this before wielding the knife too enthusiastically.