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News Analysis: NMC under scrutiny

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Ministers have announced that allegations of bullying, racism and financial mismanagement at the nursing regulator are to be investigated.

Richard Staines reports

THERE has been a step-change in events that have seen the organisation responsible for the regulation of the UK’s 640,000 nurses and midwives facing serious allegations about how
it is run.

Last month NT exclusively reported that the NMC paid settlements to senior staff who left after working relationships broke down, two of which were worth more than £100,000 each (NT News, 26 February, p3).

Now Livingstone MP Jim Devine, a former psychiatric nurse, has made public full details of allegations of bullying, racism and financial mismanagement against the NMC in a half-hour adjournment debate in the Commons.

The allegations, as yet unproven and strongly denied by the council, come at a time when the future of self-regulation of health professionals is already under review via the white paper Trust, Assurance and Safety.

Mr Devine first raised issues about the regulator in parliament on 18 February and then submitted 11 questions to ministers (NT News, 4 March, p3). Similar concerns were subsequently raised by John Smith, MP for Vale of Glamorgan.

Earlier this month NT reported that the Charity Commission – the NMC has charitable status – confirmed it had been notified of concerns about the regulator and was considering whether to conduct an investigation.

The Privy Council, the parliamentary body to which the nursing regulator is ultimately accountable, also confirmed it had been contacted in connection with the concerns (NT News, 11 March, p3).

In his speech to the Commons last week Mr Devine told the Commons the NMC appeared to be ‘fundamentally dysfunctional’, with an ‘ingrained culture of bullying and racism’.

‘The culture at the NMC is reflected by the fact that some 20 complaints and counter-complaints have been filed in the past year against eight current and two previous members of the council, and I understand that there are more complaints in the pipeline,’ he said.

Legal expenditure on governance issues and costs relating to investigating complaints from council members were ‘well over’ £120,000 in 2007, Mr Devine told MPs. This year, he said expenditure could be in the region of £300,000 – the equivalent of the £76 registration fees of nearly 4,000 nurses.

‘Staff whose faces do not fit are subject to disciplinary action, paid off and required to sign confidentiality agreements,’ he added.

Mr Devine added: ‘As a self-governing regulator, whose purposes are public protection and the public interest, the NMC should be run with integrity, competence and transparency.

Unfortunately, that appears not to be the case.

‘It appears to be a fundamentally dysfunctional organisation where the priority of those in control is to maintain the status quo at the expense of proper transparency and good governance. Its funds are being misspent and staff time is being misused,’ he said.

Dr Richard Taylor, MP for Wyre Forest and a member of the Commons health select committee, told MPs that he
too had been approached with ‘very serious allegations about probity and conduct’ at the NMC.

Mr Devine read out anonymous statements from ‘whistleblowers’ at every level of the organisation, including former staff, former members, and both current and former council members.

A union representative, who was also quoted by Mr Devine, described the NMC as ‘dysfunctional’ and ‘out of control’, and said: ‘it is not just the staff but council members are being harassed and bullied’.

Staff who raised grievances about the way the NMC was run had been investigated by
the individuals in question, the union representative’s statement added.

Another statement from a former council member said funds – raised from nurses’ registration fees – had been misspent and trustees prevented from doing their jobs.

A second council member’s statement warned that current members were scared of bullying and harassment.

A third statement, from a former member of staff, said: ‘I was very happy when I joined the organisation, loved the job and the working environment.

‘Things changed when the new chief executive arrived and I was very soon out of favour… the changes made to the culture of the organisation resulted in a very unpleasant, punitive and negative working environment lacking transparency.

‘Sarah [Thewlis] held what she termed “soft chair conversations” with staff who were not in favour. This involved me being given at one point what she termed a bollocking,’ Mr Devine quoted.

So what happens next?

The government has no power to intervene directly in the regulator’s internal operations at present because the NMC
is an independent professional body. But the public airing of such sensitive allegations
in the Commons has forced it to respond.

Health minister Ben Bradshaw told MPs he would be writing to the healthcare super-regulator, the Council for Healthcare Regulatory Excellence, and the Charity Commission to ‘encourage’ it to investigate Mr Devine’s claims.

If these investigations do not resolve the problems, Mr Bradshaw said that he would call on the Privy Council to intervene – a step he described as the ‘nuclear option’, which could potentially result in a public inquiry.

‘It is important to me as well as to thousands of nurses and midwives that the workings of the NMC and all regulators should be open and transparent. That is crucial to maintaining patient and public confidence,’ Mr Bradshaw said.

The NMC, for its part, has launched its own internal inquiry into the criticisms and has robustly denied the accusations since they were made public.

Ms Thewlis was unable to comment last week. However, the NMC has produced a statement defending its record on governance and financial management.

‘The NMC’s workforce is extremely diverse, highly competent and committed to delivering excellence in regulation and public protection and will continue to do so,’ it said.

Regarding its financial management, the regulator reiterated its position that recent fee increases were needed to pay off a debt inherited from its predecessor, the UKCC, which it replaced in April 2002.

The organisation’s debt is set to be reduced from £7.6m at the end of the last financial year to around £1.6m this year, the statement added.

‘To date, all of the allegations regarding the NMC have been made either under parliamentary privilege or to the media,’ the statement went on to say.

‘We are disappointed that none of the individuals who have made these allegations have chosen to approach
the NMC.’

The regulator also said that it welcomed the investigations by the CHRE and the Charity Commission. ‘Independent scrutiny will give us a chance to demonstrate that the NMC is a fully accountable, open and transparent organisation, which does not tolerate discrimination of any kind,’ it said.

Whatever the outcome of the various inquiries, nurses will undoubtedly be disturbed by the allegations made by Mr Devine about the organisation charged with regulating their fitness to practise.

‘It is vital that public confidence is restored in the NMC as soon as possible,’ the unions Unison, the RCN and Unite said in a
joint statement.

Jim Devine’s allegations

‘It the [NMC] appears to be a fundamentally dysfunctional organisation.’

‘Its funds are being misspent and staff time is being misused.’

‘Poor financial management has resulted in nurses and midwives being faced with nearly a doubling of their annual fees.’

‘There appears to be an ingrained culture of bullying and racism as a means of preventing good governance.’

The NMC’s response

‘The NMC rejects allegations made by Jim Devine MP. There is an open invitation to Mr Devine and his colleagues to meet us to discuss their concerns and to give us an opportunity to respond. We are saddened that they felt unable to do so.’

‘We very much welcome the minister’s assistance and the opportunity for independent scrutiny of our governance and operating processes by the Charity Commission and the CHRE.’

‘The NMC’s workforce is extremely diverse, highly competent and committed to delivering excellence in regulation and public protection and will continue to do so.’

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