Nurses will pay £100 to register with the Nursing and Midwifery Council from February, following a decision by the regulator today.
The NMC council has chosen to increase the fee by 32% from £76 to £100 for two years, after which it will rise to £120. This replaces its original plan to move straight to £120 in January 2013, which would have represented a 58% increase.
The fee rise will have to approved by the Privy Council. However, today’s decision at the NMC council’s latest meeting in London seemingly brings to an end the saga that first erupted in May, when it first proposed increasing the fee.
Since then the NMC has doggedly stuck to its position that the hike is necessary to shore up its finances and protect the public, despite anger from registrants and opposition from unions.
Its current registration fee of £76 per annum was implemented in August 2007, and generates income of £52m per annum. However, the regulator has seen a significant rise in fitness to practise referrals in recent years, which it predicts will rise even further over the next few years.
According to council papers, direct expenditure on fitness to practise in 2011-2012 was £31m, a 50% increase on the prior year. Total NMC revenue expenditure was £61m and total revenue was £53m, creating a deficit of £8m, which was effectively funded by reserves.
The government offered the regulator a grant of £20m earlier this month to ease its financial problems and negate the need for such a steep fee hike. The NMC chose to accept the grant at the meeting today.
The regulator’s ruling council discussed four options this morning at its latest meeting, some of which included accepting the grant and some not.
One option would have seen no fee increase and the £20m grant accepted. But it would almost certainly have resulted in a scaling back of fitness to practise and other regulatory activity, meaning the NMC would be failing to fulfil its core remit of public protection.
The second option would have seen the £20m grant rejected and resulted in the annual registration fee rise to £120 next year, as originally proposed by the NMC.
The third option, which was chosen by the majority of council members, will see the fee rise to £100 for two years and then £120 after that. This option includes the NMC accepting the government grant.
A fourth option would have seen the fee rise to £95 in 2013-14, £105 in 2014-2015, £120 in 2015-16.
As revealed by Nursing Times this week, the NMC has bowed to pressure and commissioned financial consultants KPMG to audit the sums behind its fee rise.
The regulator had previously rejected such a move and claimed its business case was sound, despite two letters from former health secretary Andrew Lansley asking it to commission the work.
The results of the KPMG review were also due to be presented this morning at the council meeting.
Despite being a lower fee hike than previously threatened, Unison descibed the 32% increase as “unfair and disproportionate” in the light of the £20m grant offered by the government.
Unison head of nursing Gail Adams said: “This is an appalling move by the NMC. There is no justice in making nurses and midwives – who have had no pay rise for two years – pay for the past financial mismanagement of the NMC.
“The NMC could, and should have postponed this decision and used the time to rebuild the trust and confidence of registrants. There was nothing to stop the NMC from freezing registration fees and reviewing the situation next year; they could then use the grant to start addressing the backlog of fitness to practise cases.”
Royal College of Nursing chief executive and general secretary Peter Carter said: “Nurses across the UK have repeatedly objected to the proposed hike in NMC fees, at a time when many are struggling financially.
“We are staggered that with an increase of over 30%, the NMC is still asking for frontline nurses to pay the penalty for a problem which is not of their making. We are also staggered that nurses are still being asked to pay for the failures of their regulator, with no real assurance that the fundamental problems will be solved.
“We still need to see the outcome of a full financial audit, and the profession needs to have confidence that the lessons are learnt from this fiasco and that there will be ongoing, high-level scrutiny of the organisation. Without this, nurses and the government could end up throwing good money after bad.”
“The RCN welcomed the Department of Health’s offer, which our members have called for repeatedly. Now more than ever, they will want to be reassured about the long term future of their professional regulation. A strong and effective nursing regulator is vital for the public, patients and the future of the nursing profession.”
Louise Silverton, director for midwifery at the Royal College of Midwives, said: “‘The RCM has worked hard to get the best possible result for its members, and we are pleased that we’ve achieved something by lobbying for the £20m grant from the government that the NMC has accepted.
“Many of the NMC council members took on-board our concerns about the effects the fee increase will have, particularly on those who only work a few hours a week and on newly qualified midwives.”
She added: “No one is happy to see an increase, but the NMC have committed to an annual review of the situation which will allow us to see if the NMC’s assumptions about its finances are accurate. The NMC’s suggestion that fees could go down if predictions aren’t as they expect is welcome.”
More details on the NMC’s decision and response to follow. Follow @sjcalkin on Twitter for live updates from the meeting.