As you may have already heard, the much-maligned Chief Executive of the Care Quality Commission (CQC), Cynthia Bower, resigned today. I think most would agree this wasn't so much a matter of "if", as when, since her ongoing association with the organisation was reputationally untenable, and likely to be more so once the Mid-Staffordshire Inquiry report is published. Although I'm no fan of Bower's, I'm not especially optimistic about the organisation's future without her. The problems for CQC are largely structural and political; it's not that there aren't "personality" issues, rather that the politics will shape the personality that can head the organisation.
A change of leadership won't be able to turn around the juggernaut of a light-touch and poorly-resourced regulatory model. I do feel that what is missed in the press's feeding frenzy on Bower herself (and Williams, to a lesser extent) is how far the problems at CQC relate to the way it was set up. A few months ago I watched Labour MP Margaret Hodge cross-examining the CQC's leadership in her role on the Public Accounts Committee, but Hodge herself voted for the legislation that birthed the CQC in its current form. Like genetics, a statute won't determine everything about the creature it produces, but it does go some considerable way towards shaping it. The Health and Social Care Act 2008 did not seek to produce a body that could drive through improvements in the sector (so much as remedy failings), did not create a mechanism for handling complaints, and omitted several useful powers that the CQC could have done with to deal with problematic providers. And the Department of Health - under red banner, as well as yellow and blue - must bear some responsibility for the shape the CQC has taken. Yet I'm sure they're pretty relieved when Bower and Williams take the flack for a failed regulatory model.