Nurses could be forced to pay fines and legal costs when found at fault in fitness to practise cases, under a plan presented by legal experts to ministers.
The government would gain the power to introduce a system of “financial penalties and costs awards” if the recommendations of a consultation paper on the future legal structure of the Nursing and Midwifery Council and other professional regulators are adopted.
Last week’s paper was published by law commissions of England and Wales, Scotland and Northern Ireland after the government asked them to review how the current regulatory system could be made “clearer, simpler, more modern and more consistent”.
The use of financial sanctions in health regulation was “contentious” because the system could be seen as already properly funded by registrants’ fees, the law commissions acknowledged. But they also queried why “good professionals” should be expected to “subsidise the miscreants”.
The paper held back from recommending whether financial sanctions should be introduced by all regulators but said the government should be given the power to implement such a move if it chose.
However, it did recommend that nurses should be allowed to remove themselves from the register to avoid fitness to practise proceedings, as is currently only the case for doctors. All regulators should be able to mutually agree “voluntary erasure” from the register, the paper said.
It also called for the regulators to be “greater autonomy to adopt their own approach to regulation in light of their circumstances and resources”, but only after holding a consultation on any changes.
The government should be given “default powers” to intervene where a regulator has failed and be given the power to abolish or merge regulators, the paper said.
This would replace the current position in which the NMC and other regulators are accountable to the Privy Council - the secretive body of advisors to the Queen - rather than a government department.
A consultation on the commission’s proposals will close on 31 May.
Royal College of Nursing head of policy Howard Catton said it was essential any changes did not result in the loss of professionally led regulation and that nurses’ NMC fees were not used to “subsidise” other regulators with fewer members.
Unison head of nursing Gail Adams added that “robust consultation” must be a condition of allowing the regulators more freedoms to set their own rules.