SKETCH: Who Regulates the Regulators – and can we give them an axe to do it?


It’s hard to summon the invective to describe the nice young regulator who’s going to head up the NHS’s Monitor.

Pleasant, modest Dominic Dunn (£63,000 a year for three days a week) is there to provide another layer of strategic obfuscation in the multi-billion miasma of the NHS.

That’s not written in to his job description but he is certainly an elusive target.

When asked a direct question – is it your job to promote competition in the NHS? – he answered: “Not to promote competition, but to address anti-competitive behaviour.”

Or again: “We don’t have enough radiotherapy in my part of the country. Is it your job to address that lack?” He said: “I certainly agree with avoiding the situation where there is enforcement action needed.”

When the revolution comes, these people will be carrying bedpans.

Chairman Stephen Dorrell asked him what he’d like to be remembered for after a decade running the joint. “Well, er I this it’s knowing how you define success.”

Oh yes. Defining success, that’s the key to it. These people do what they do and call it success.

But judging from the administrative esperanto he spoke, success won’t be getting nurses to wash their hands. It won’t be stopping staff telling old people to “go in their beds” instead of taking them to the toilet. Success won’t be rooting out hospital heads responsible for deaths by incompetence, negligence and sadistically indifferent staff.

No, success will be aligning the strategic priorities and navigating the transitional issues between national integration and intrasectoral competition.

NB: When Malcolm Grant appeared before the committee to be confirmed as the chair of NHS England they did throw a few bed pans at him and nearly voted the appointment down. That really is meritorious behaviour in a committee.




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Quote of the Day

IDS responds to Juncker’s pints analogy earlier:

“Mr Juncker knows a little bit more about the bar than perhaps many of us do.”

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