The nursing and midwifery regulator has admitted that even if it accepts a government grant of £20m, nurses’ and midwives’ annual registration fees will still have to increase.
Ministers offered the Nursing and Midwifery Council (NMC) a one-off grant to ease an unpopular 58% increase in the fees.
A Department of Health spokeswoman said the money would “protect nurses and midwives from the full impact of a proposed registration fee rise of almost 60%”.
But the NMC’s chief executive Jackie Smith said that nurses and midwives would still face a hike in fees, even if the body accepted the grant.
She told the Commons health select committee that there was a shortfall between the amount of money generated by fees and the cost of running the organisation.
Fitness to practise hearings cost £43 million and the general cost of running the NMC is £30m - a total of £73 million - but the amount of money generated by fees - the organisation’s only income - is £52m, she said.
The NMC has recently consulted on increasing the annual fee from £76 to £120.
But unions condemned the move, saying it was “inappropriate” to increase fees while NHS workers are in the midst of a pay freeze.
“We recognise that this is a particularly difficult time to even think about increasing fees,” said Ms Smith.
“We recognise the impact but we are afraid that there is no other alternative.
“Even if the council accepts the grant, fees will still need to go up to deliver in terms of fitness to practise.”
The NMC’s chairman Mark Addison said that the £20m grant, if accepted by the council, would be used to clear the backlog of fitness to practise cases.
“The focus of the £20m will be linked to the clearance of the backlog,” he said.
MPs also asked Ms Smith whether part-time or graduate nurses should pay a lower fee.
She said: “We looked at a number of things but it is very difficult for us to administer a system that has variable fees - we do not know where everyone works, we do not know how many hours they work.”
The NMC, which regulates the UK’s 670,000 nurses and midwives, said that in the last few years it has received an “unprecedented increase” in the number of referrals about the fitness to practise of nurses and midwives.
To cope with the soaring cost of fitness to practise hearings, the organisation said it would raise registration fees - which nurses and midwives have to pay to work in the UK.
It has a backlog of 1,400 cases which still need to be adjudicated on.
Ms Smith said she hoped the case load would be cleared by the end of 2014.
“We have to invest our time and resources in clearing problems in the fitness to practise process,” she added.
The NMC Council will meet on October 25 to decide whether or not to accept the grant.