A Labour shadow health minister has raised concerns to Nursing Times that Brexit will lead to a rise in nurse registration fees.
Justin Madders said he feared that the cost on regulators to meet extra responsibilities placed on them by the UK’s withdrawal from the European Union could eventually fall on applicants or those in practice.
“I’ve got concerns about what that means for patient safety”
Currently, a law is in place that allows nurses from European Economic Area (EEA) countries to have their qualifications automatically accepted in the UK without further checks.
However, after March 29, this legislation – called the Mutual Recognition of Professional Qualifications Directive – will cease to apply.
The Department of Health and Social Care (DHSC) has laid out new legislation that will come into force in the event of a no-deal Brexit that maintains a similar system for a period of two years but includes some key changes.
For example, under the new rules, regulators such as the Nursing and Midwifery Council will have the power to blacklist any EEA qualifications they deem to be not comparable to those given in the UK.
“It is important that we do not add unnecessary administrative delays”
In addition, the Mutual Recognition of Professional Qualifications Directive allows EEA nurses to work in the UK on a temporary or occasional basis while remaining resident in their home country and without needing full registration with the NMC.
However, after Brexit this will no longer be possible, even if a deal is struck, because it relies on freedom movement rules in the EU.
Mr Madders said he was concerned that any extra costs that may be brought onto regulators through these changes would have to be recouped in the long-run by upping registration fees.
“I think we would be worried that the regulator would feel that they’ve got no choice because they’ve been given these new responsibilities without recourses to deal with them,” he told Nursing Times.
He added that increased fees could put international nurses off applying to work in the UK.
“If the costs are put on to the individual applicants then it’s a competitive world, people will look at their options and if they feel there’s a country which is making every effort to attract them and a country where they are actually putting fees and hurdles in the way they might be less incentivised,” he said.
The NMC made clear to Nursing Times that it had no plans to increase fees as a result of Brexit and to do this would require a public consultation process and approval from parliament.
However, Nursing Times has learnt that the government is not ruling out a rise in annual fees as a result of the no-deal policy but that the increase would be “in the tens of pence”.
Meanwhile, under the new rules, UK regulators will also be blocked access to an online database tool called the internal market information (IMI) system that allows intelligence to be shared across the EU.
The IMI system provides an alert mechanism that makes regulators aware when there are issues around a professional’s fitness to practise.
Mr Madders, Labour MP for Ellesmere Port and Neston, said the loss of this database was a “worry” and could impact patient safety.
“I’ve got concerns about what that means for patient safety if the current alert system isn’t there,” he added.
Danny Mortimer, chief executive of NHS Employers, said it was “critical” that a mechanism was put in place to process applications to the different registers in a ”timely way and which provides the assurance employers and the public expect”.
“Any individual considering moving to the UK to work in a regulated healthcare profession will want clarity and certainty around what they are required to do to gain registration,” he told Nursing Times.
“At a time when the NHS has 40,000 nurse vacancies and there are more EU nurses leaving than joining, it is important that we do not add unnecessary administrative delays to a system which needs to recruit people at scale and pace,” he said.
The statutory instrument that will replace the Mutual Recognition of Professional Qualifications Directive has been approved by the Commons and is due to be debated by the Lords next month.
It protects decisions already made, allows applications made before exit day to be concluded under current arrangements “as far as possible” and gives professionals practising in the UK under temporary and occasional status to continue to do so until such registration expires.
“We value the enormous contribution EU workers make to the health and social care sectors”
The document states that holders of UK qualifications that have been registered in EEA countries will continue to be registered, but after March 29 future decisions will be in hands of individual EU member states if there is no deal.
Emma Broadbent, director of registration and revalidation at the NMC, said it had been working closely with the DHSC on the new legislation that would extend the automatic recognition regime for two years once the UK left the EU.
“Bearing in mind continuing workforce pressures and the time it may take to determine the UK’s future relationship with the EU, we think that this is a sensible approach,” she said.
A DHSC spokesman said: “We value the enormous contribution EU workers make to the health and social care sectors and want them to stay long after the UK leaves the EU.
“In the event of a no-deal exit from the EU, EEA nursing qualifications will continue to be recognised as they are now,” he said.
The spokesman added that the department would seek to put in place arrangements to ensure nursing qualifications and experience gained within the NHS were recognised in EU member states in the same way they were in other countries.