Regulatory Strategies for Safer Patient Health Care

Health care governance has been undergoing substantial change since the beginning of the twenty-first century. Responsive regulation involves multiple regulatory actors and multiple mechanisms, beginning with persuasion, but with the capacity to range upwards to punishment for the most recalcitrant. Malcolm Sparrow argues that the central purpose of regulation is the abatement or control of risks to society, while the essence of the regulatory craft is to ‘pick important problems and fix them’. The Quality in Australian Health Care Study (QAHCS) conducted in 1995 still provides the most comprehensive estimate of the scale of adverse events in Australian public hospitals. Extrapolating the QAHCS findings to 2003–04 Australian public hospital admissions suggests an annual hospital toll of 6300 preventable deaths from adverse events. Adverse events can be classified in many ways, but the main point is that an enormous variety of things can go wrong—which makes it difficult to address the multifarious causes.