‘Governance, Regulation and Small Businesses’. Where does it all fit into dental practice?

Some thoughts on how governance applies to the smaller business entities in the context of government regulation.

This article was written by Derek Brauders Director and Company Secretary at Dental Compliance Ltd in the context of the 2019 entry of HIQA, the Health Information and Quality Agency, into regulatory oversight of Medical Ionising Radiation.

Corporate governance is often thought of as referring to large organisation or businesses; how the Board runs the organisation and directs it. More recently, the concept of governance has expanded to include public sector organisations, usually dropping the “Corporate”. The goal is to demonstrate if public money is being well spent, if services are being suitably provided and that the organisation is trustworthy.

But increasingly we are seeing a third aspect of governance presenting itself: that of a regulated environment interacting with small businesses within the private sector such as Dentists (or similar healthcare professions).

A Useful Definition: Corporate Governance comprises the systems and procedures by which organisations are directed, controlled and managed. (Code of Practice for the Governance of State Bodies 2016, Introduction).

This definition is a short, straightforward explanation of what may be looked for by any Regulator (such as HIQA), and indeed this Code outlines the expectations that the government has of its Regulators (Compliance Requirements, p7). There are more complicated definitions and more oriented towards the larger private sector organisations, but good governance by the smaller entity (sole dental practitioner and upwards) may not always fit, and governance has to be adaptable to some degree if it is to be successful. Ideally, governance should be as clear and concise as possible with the least complicated or complex structure. While often time consuming to lay out in the first instance, the process should be much more easily updated as required.

Evidence of how the entity is directed, controlled and managed through presentation of systems and procedures, which are kept up to date and regularly reviewed, assists in demonstrating to two key stakeholders (the Regulator and the general public – including patients) that the business entity is trustworthy, well managed, and provides assurances that the professional practice of the entity is properly carried out. Ultimately, that achieves the aim of governance with respect to the smaller business entity and regulation.

I believe that the public sector codes, such as the Code of Practice mentioned, but also HIQA’s own Code of Governance (specifically Section 1) provide the most supportive language to describe what is required of the smaller business entity, and can be used to great effect to identify and create one’s own governance process, rather than the more business oriented codes and explanations.

Dental compliance Ltd would like to thank Aidan Horan of the Governance Forum, Institute of Public Administration, for providing some additional detail and resources for subject.