The rise in NMC registration fees proved controversial. With nurses questioning exactly what they are paying for, Simon Daniels asks if the fees are justifiable
In August 2007 the NMC increased its annual registration fee from £43 to £76 – an effective increase of 76%. It argued there had not been a significant rise since 2002, when it inherited a crippling overspend and poor stock market performance from its predecessor, the UKCC. It also stated that, prior to this increase, all 685,000 registered nurses were given ample opportunity to voice their opinions in a number of forums run by the RCN, NT and NMC Quarterly.
The response was disappointing to say the least, and borne out of apathy or sheer frustration in seeing the consultation period as nothing but a paper exercise. Whatever the reasons, nurses have yet another financial burden heaped on them by an organisation with charitable status that cannot function without donors’ fees.
What value for money do we get from registration? We are all supposed to operate under, and abide by, a professional code of conduct laid down by the NMC. Common sense aside, how many nurses actively consult and strictly operate according to the sacred ‘code’? One condition of our fitness to practise requires us to participate in at least 35 hours’ training per year to show continuing education and post-registration education and practice but what safeguards are employed to ensure this is carried out?
The NMC offers advice on a number of topics but cannot legally represent nurses – this is why we join a union. Employers can access the NMC via the internet to check on nurses’ registration – for which there is no charge. We also have to make a Criminal Records Bureau (CRB) application whenever we change jobs, at a cost of £46. Shouldn’t the NMC – as upholder of public safety and professional accountability – be able to work with the CRB and provide a portable document akin to a driver’s licence or passport that stays with us wherever we go? If there are concerns over potential infractions, it could amend or cancel the document accordingly.
W1B 1PZ is one of the most expensive post codes in the country and the NMC headquarters there was recently valued at over £15m. In addition, the building was refurbished this year, costing over £4.4m. Is this really value for money? Especially when thousands of charities have to beg, steal or borrow to rent out-of-town units or work in inadequate premises, accounting for every penny to satisfy frugal-minded trustees that donors’ money is being spent wisely.
What other public services require their employees to pay annual registration fees? We don’t ask firemen to stump up £76 a year just to revalidate their devotion to duty – just as we don’t expect police officers to rejoin their respective constabularies every year. Such a suggestion would be treated with universal derision.
The truth is the NMC is a faceless organisation that survives only because we are forced to pay for it. It’s an insurance policy that benefits everyone but us. I know the general public needs protecting and nurses should adhere to a set of professional principles but isn’t enforcing and paying for this up to our employers? As it is, we are saving the government £23m a year by funding the increase in these fees ourselves.
I approached the NMC for information on these issues and received a standard leaflet that read like a corporate version of the nurse’s Professional Code of Conduct. It’s peppered with stirring phrases such as ‘hard-fought self-regulation’ and ‘professional standards for performance and ethics’. It also details the public consultation phase before the increase and states: ‘You clearly told us that we should have sufficient funding to exercise our responsibilities but expressed concern and anger at our proposal to increase the fees to £80. Our council decided to limit the fee increase to £76.’
Not exactly a climb-down, even with the £14 tax relief on fees. Pursuing the issue seems futile – like asking your bank why it takes a week to cash a cheque but can process a debit card payment in a few hours.
Simon Daniels is a mental health rehabilitation nurse in Stoke-on-Trent