Resilience and regulation – antithesis or a smart combination for future healthcare service improvement?

Abstract

Researchers and policymakers wonder if regulation and resilience can go together and be a smart combination for healthcare improvement. Briefly, regulation is often thought of as directives from above, and resilience as the ability to withstand adversity through adaptation. Combining the two, we argue that regulatory resilience should play a key part in future solutions to handle the increasing system pressures. Based on insights from research on how resilience and different regulatory strategies intertwine, we suggest future directions We ask how regulators and external inspectors may design and enforce a regulatory regime, and thereby contribute to resilience capacities of adaptation, anticipation and learning in complex systems. Such a focus contradicts the classic assumption which sees regulation and resilience as distinctive concepts – or even in direct conflict. As resilience requires flexibility and adaptive capacity, it presupposes sufficient autonomy to make decisions. Although different regulatory approaches are taken across the globe and co-exist within national systems, regulation is often perceived –and portrayed – as an instrument of prescription, seeking compliance. Yet, few studies have investigated, and fewer still contradicted, these assumptions.