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Government offers NMC £20m to reduce fee hike


The government has offered a £20m grant to the Nursing and Midwifery Council in a bid to reduce the size of the proposed fee hike.

The regulator’s unpopular proposal to increase the annual registration fee by 58%, from £76 to £120, was unveiled in May. It says it needs the increase to raise funds to cope with its existing queue of fitness to practise cases and an anticipated increase in future referrals.

The fee rise is expected to raise an additional £29m for the regulator. Therefore, even with the £20m from the government, it is likely the NMC would still want some level of fee increase to balance the books.

Nursing Times understands the Department of Health hopes its intervention could see the fee rise lowed to around £100.

An NMC spokeswoman said the regulator would decide whether to accept the grant at its next council meeting on 25 October, when a final decision on whether to go ahead with the fee rise is also expected to be taken.

“We welcome the government’s offer of a grant to give us further options to contribute to the costs of regulating nurses and midwives,” she added.

However, the regulator has previously ignored two requests from the government to commission an external audit of the business case for the fee rise.

Announcing the grant today, new nursing minister Dan Poulter said he hoped the cash would help the regulator “get back on its feet”, operationally and financially.

“It is important that organisations like the NMC are in the right shape to properly perform their job of protecting patients,” he said.

“I am also mindful that in these times of pay restraint, it is not right that hard working nurses and midwives are burdened with the full financial cost of improving the NMC’s fitness to practise function.”

Royal College of Nursing chief executive and general secretary Peter Carter said: “The Department of Health’s offer is to be welcomed and is something we have been calling for. It is clear that the NMC has been facing a number of significant challenges for some time and we would urge the NMC council to accept the offer as soon as possible.”

He added: “We believe that the proposed independent audit of the financial basis and assumptions behind the proposed increase still needs to be carried out swiftly, and its recommendations taken on board. This is essential for nurses and midwives to have confidence in the NMC as their regulator.”

Unison head of nursing Gail Adams said: “The government grant will come as a welcome relief to nurses and midwives who simply cannot afford to pay the massive 58% increase in registration fees that the NMC is proposing. The council must use this grant to keep registration fees down and help nurses who have had their pay frozen for two years and are now struggling just to make ends meet.

“The grant is a unique opportunity to rebuild public confidence in the NMC as an organisation and, more importantly, to regain the trust and respect of registrants.”


Readers' comments (24)

  • good, this is an outrageous situation that the NMC had expected us to bail them out of.

    I'd still like to know what exactly we get for our annual fee - a little paper card, information on a database that we provide for them. It can't cost 76pounds just for that.

    Why any increase? they are not there for the nurses benefit at all so what are we paying for?

    If they have an increase in FtP cases then perhaps they need to realise that some nurses should not have been allowed to go on the Register in the first place and that their checks were inadeqate and ineffective.

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  • I would not mind paying an increased fee to the NMC if I actually benefited in some way from their services. Since they exist to protect the public and not to protect nurses I agree that the government/public should contribute to their running costs. If they didn't waste so much money on trivial fitness to practice cases which could easily be dealt with through internal NHS disciplinary procedures they would not be in this financial mess.

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  • Unions take note: you need to fight your members corner here and say NO to any hike in fees.

    If the NMC need to make savings then they need to look at finding these savings internally. Now that the NMC no longer offer nurses advice, they can surely sack the people who used to provide this advice or answer their telephone etc.

    If the NMC does need to find more money then it is only right that it comes from government and not nurses.

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  • So the fee rise could still go ahead but not quite as high as previously suggested
    We might now need only to find an extra £24 to remain on the register. Now Maths was never my strong point but the NMC say they needed an extra 29 million and if the government give them 20 million which is a shortfall of 9 million how is it we will still be expected to pay such an increase

    Still feels we are bailing them out and with this proposal they would be getting well in excess of the 29 million they are asking for.

    Lets hope they accept the offer of the 20 million when the decision is made at their meeting next month..... why would they not accept it !!!!

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  • Susan Markham

    This may not be such good news at it initially seems.

    “Nursing Times understands the Department of Health hopes its intervention could see the fee rise lowered to around £100.”

    If that’s the case then someone is being a little greedy here. Do the math and crunch some numbers...

    The NMC wanted to raise an “additional” £29m for itself. To do this it proposed to raise the registration fee by 58% from £76 to £120. So a £44 increase = 58% = £29.

    So now the government is stepping in and putting up £20m of the “additional” monies needed by the NMC. This leaves a shortfall of £9m. If the shortfall is to be paid by raising the registration fee then it would only have to go up by 4.5% to make up the missing monies.

    £76 + an increase of 4.5% = £80.50... not £100. In fact if the registration was in fact raised (not lowered as the DOH imply) to £100 - it would generate an extra £15.5m, £6.5m MORE than the NMC said it actually needed at the start of this year.

    So if the government gives £20m and the fee is increased to £100 where is the extra £6.5m going to go?

    If the nursing minister, Dan Poulter, really is “mindful that in these times of pay restraint, it is not right that hard working nurses and midwives are burdened with the full financial cost of improving the NMC’s fitness to practise function” then surely he would only allow the registration fee to rise to £81 (rounded up) in order to cover the £9m needed to cover the shortfall.

    The other interesting aspect of this story which may put a damper on this seemingly “good” news...

    “The NMC has previously ignored two requests from the government to commission an external audit of the business case for the fee rise.”

    If the government gives a large grant of £20m to the NMC that would entitle them to send in their own auditors to go through all the NMC’s books and see how its monies were being spent - information that I don’t the NMC would like to be shared with the nursing organisations.

    This lack of transparency and accountability is probably the reason why the NMC insists that Nurses fund their task of “protecting the public” rather than being funded by (and directly accountable to) the government’s Auditor General’s department.

    So, in my opinion, I wouldn’t be surprised to see the NMC refuse this £20m grant and insist that the fee hike goes ahead as proposed.

    Just remember that if you see any fee hike above £5 a year (bringing the annual fee to £81) then you are looking at a rip-off (or rather you are being ripped off.)

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  • Susan Markham

    Sorry, the 3rd paragraph should have read -

    "The NMC wanted to raise an “additional” £29m for itself. To do this it proposed to raise the registration fee by 58% from £76 to £120. So a £44 increase = 58% = £29million."

    Not £29.

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  • Susan Markham

    Excuse me for unceremoniously barging back in again but I have just re-read my initial post in this thread and I must say I am mighty annoyed with myself - BAD SUSAN! BAD BAD SUSAN!!!

    I said I was going to crunch some numbers and I carried away with doing exactly that. I played at being an accountant and ended up by virtually saying that a 4.5% increase in registration fees was quite acceptable. What was I thinking? Well I wasn’t thinking as a nurse for a start!

    Did I really say a 4.5% increase was OK? Hmmm... Inflation in the UK is currently around the 4% mark and has been for the last few years. So the cost of living has gone up around 12-16% over the last few years. Ermmm... remind me, how many pay rises did nurses get over the last 3 or 4 years?

    So obviously Nurses can easily afford a 4.5% increase in registration fees - it’s a mere drop in the ocean compared to their recent pay increases... NOT!

    Shame on me for getting carried away with the numbers - I got so excited about the math I forgot about the realities.

    If I factor “reality” into the equation then not only should the government “anti-up” at least the full £29m but they should get in there and find out where the NMC is wasting all the money in the first place.

    I completely lost sight of the fact I am a nurse and therefore I should be saying that the registration fee should be “lowered” in line with the annual effective deflation in nurses salary.

    Reduce the registration fee by 10% to £68 p.a. (to ‘roughly’ represent the effective erosion in nurse wages over the last 3 years) and let the government give a £50m grant to the NMC to maintain their own estimation of their ‘supposed’ running costs.

    The added bonus is that the government will be able to get into the NMC’s books and see exactly where all that money is bleeding off to.

    £50m from government may sound a lot - but it is a drop in the ocean compared the amounts that the current Coalition is giving away to overseas corrupt regimes masquerading in the form of “foreign aid.”

    If you thinking I am just being cranky - read these recent stories...

    “Cabinet Minister Andrew Mitchell’s unilateral decision on the last day in his previous role as International Development Secretary to hand £16?million of British taxpayers' money to the brutal dictator of Rwanda, President Paul Kagame...”


    “Foreign aid spending to overtake police budget: Taxpayers to fork out £12.6billion a year on international aid in 2014“


    “A study last week by the independent think-tank the Institute Of Public Policy Research calculated that the Government will have to cut make a £3.7?billion cut at the Department For Education — equivalent to more than 80,000 teaching posts. Yet incredibly, Department For International Development ’s budget will have risen 50 per cent over the duration of this Government, rising from £7.8?billion in 2010 to £11.5?billion by 2015.”


    So, no, I am not being mean spirited... a £50m donation (for at least one or five years) is absolute peanuts for the government to stump up and “protect” its nurses. Almost like a small “tax-break” (like the Tories give to their well-off chums) for us cash-strapped nurses.

    But of course... in reality... I do not see the NMC allowing the government’s auditors to get a foot in the door and see where (and into whose pockets) the money “really” goes.

    So, somewhat pessimistically I admit, I expect the NMC to reject the government’s offer of a £20m grant and the consequently the NMC will insist on increasing its annual fee to £120.

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  • The government should save their handout money to the NMC and order a handover of their books for scrutiny!

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  • Susan Markham

    Roger Hodgson | 15-Oct-2012 8:05 pm

    "The government should save their handout money to the NMC and order a handover of their books for scrutiny!"

    I totally agree but whilst the NMC is effectively a financially "private" organisation then the government is unable to do an official audit and see where the "big" money is going.

    The NMC, currently. get their money from UK Nurses and therefore they do not have to answer to the UK Government.

    The NMC appoints its own auditors and publishes its own version of the subsequent accounts.

    It's a rather odd situation that the government can't audit the NMC's accounts.

    Think about it...
    who pays the nurses wages? The NHS.

    Who pays the NHS? The Government.

    Where does the NMC's registration fee come from? Nurses Wages.

    So then, effectively, the Government indirectly pays the NMC registration fee through the fact they pay the nurses wages...

    Shouldn't the government already have a vested interest in where their money is being spent?

    On top of all this... who pays the Government? Remember... Government does not create money itself - it merely raises money for itself through taxation.

    Yes of course - it is the taxpayer (which includes nurses) who pays the Government.

    So try to understand this (because I certainly can't) The government (which actually has a zero GDP) taxes working people to pay for the NHS. The NHS then employs nurses and then taxes them a percentage of their income which goes back to the government (which has still done nothing to enhance the GDP.)

    Nurses pay VAT and tax on everything they buy or consume (including heated Cornish pasties) and that money goes back to the government (who still haven't "produced" anything to enhance the GDP.)

    Nurses are then told, by a self appointed, independent regulator, that they have to stump-up a 58% increase in annual fees for their right to continue to practice in the very National Health Service that their own taxes (and salaries) are paying to run?

    Good Lord, even the Italian Mafia in old New York could have come up with such an ingenious "protection" scheme.

    "First off you pay us to protect you against getting ripped off, then you pay us again so's we don't rip you off even more!"

    One faraway day - maybe... the NMC's books will be open to the general public... then we can all have a good chuckle about it... NOT!!!

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  • With a Fee hike to practice so high ,I think you may find sonme Nurses deregister due to the cost to practice,Thus we would have even less staff than we already have.
    I also would like to see a breakdown of exactly what the NMC spends our money on.
    Lets hope they accept the government grant.

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