Professional regulation, much like public health, has its worth proven by the absence of problems. Whereas for public health practice it is the absence of death from lung cancer, communicable disease or environmental hazard, for regulation it is the absence of morbidity or mortality resulting from poor professional practice.
The central purpose of this Review is therefore clear: to protect the public.
The Review sought to ascertain the potential risk posed by those public health professionals who do not come within statutory regulation, and to assess whether such universal statutory regulation would be proportional.
The Review, through its Terms of Reference answers the following questions:
- Are those individuals currently unregulated by a public health register, or sub-register, already regulated through a primary profession?
- For those individuals currently outside statutory regulation, what risk is posed by their practice not being statutorily regulated?
- What form of regulation, therefore, is most appropriate and proportional to the level of risk posed by public health practice?
Additionally, there are practical considerations about the effectiveness of regulation, even if it is supported. Specifically, these involve the proof of a prosecutable act, and the preparedness of the profession for regulation. The Review therefore also sought to establish:
- whether the types of risk presented to public safety are such that the individual responsibility and individual actions of public health professionals can be sufficiently linked to negative outcomes to make statutory regulation worthwhile; and
- whether the current thresholds of entry to the public health profession, public health training and education, and public health standards are at a level commensurate with a profession subject to regulation.
It is clear that one of the benefits of statutory regulation is that specific actions can be taken when professional misconduct or incompetence are identified and proven. These include the ability to require an individual to meet agreed professional standards; the ability to place conditions upon an individual’s practice; and the ability to de-register an individual.
The Chief Medical Officer for England commissioned this Review, in conjunction with the Chief Medical Officers of the Devolved Administrations of the UK. Recommendations will be provided to the four countries’ Chief Medical Officers.
The purpose, within the parameters set, is to consider the various available systems for the regulation of the public health workforce. The Review does this through appraising current regulatory frameworks, developments and regulatory policy within which the healthcare workforce operates. Informed by these, the Review advises on the legislative, resource and equality impacts of the regulatory options. Accordingly, the Review makes recommendations for the best regulation of public health professionals.