The announcement by the regulator for the UK’s 670,000 nurses and midwives that it intends to press for a “steep increase” in fees has provoked fury among unions representing these healthcare professionals.
The Nursing and Midwifery Council (NMC) said that the increase was needed to cover the “soaring number of fitness to practise referrals” among the profession and the rising costs of regulation.
The registration fee, which has been held at £76 since 2007, is the NMC’s principal source of income, generating an annual income in the region of £52 million
But a 48 per cent increase in referrals against nurses and midwives since 2010 and the consequent need to reduce the backlog, including a beefed up filtering process and running 20 hearings a day, have forced up its operational costs, it says.
These are set to reach “an unprecedented £42.9 million” in 2012-13. And together with the costs of the other core functions total expenditure is expected to top £73 million.
The NMC says it has taken steps to improve its efficiency, but these will not be enough to cover any future increases in referrals or to fund any improvements in infrastructure and quality.
Some of these have been demanded by the overarching regulator, the Council for Healthcare Regulatory Excellence (CHRE), following its review of the NMC.
And it has already significantly dipped into its free reserves to continue to fund activity, it says, so is left with no other option than to bump up its registration fees.
Professor Judith Ellis Interim Chair of the NMC defended the increase at a time when many nurses and midwives have endured successive pay freezes and rising costs.
“We recognise that it is a very difficult time to ask nurses and midwives to pay more for their regulation. It is clear that the rising costs of delivering fitness to practise have now outstripped the income that the £76 fee provides.”
She warned that the increase was likely to be steep. “Whilst the final level of the fee will be determined by the outcome of the consultation, I must warn registrants that an annual fee in the order of £120 is the level that is needed to protect the public and to ensure the integrity and the reputation of the professional register.”
Unite, which includes the Community Practitioners’ and Health Visitors’ Association; the Mental Health Nurses Association; and the Society of Sexual Health Advisors, said this was ‘another tax’ on hard-pressed and dedicated community nurses.
Unite’s lead professional officer, Obi Amadi said that the membership was “horrified” by the proposed 58 per cent hike, which they would have no option but to pay if they wanted to continue to practise.
“Our members resent having to pick up the bill for the failings of the NMC – which have been highlighted by two independent reviews saying how dysfunctional the organisation is,” she said, adding that the proposals were tantamount to “highway robbery.”
UNISON said that serious questions need to be asked about financial management at the troubled regulatory body, which has been in special measures since 2008, and has had six chief executives and three chairs in that time.
Gail Adams, UNISON head of nursing said: “Hard pressed nurses and midwives will rightly be very angry about plans to make them pay more to work. Many of these vital health workers and their families are already struggling to make ends meet.”
She called on the government to subject the NMC to serious scrutiny and step in and persuade the council that now is not the time to raise its fees. “Health workers should not have to pay the price for the NMC’s own failures and for the government’s failure to police this body properly,” she said.