The Nursing and Midwifery Council has proposed increasing the annual registrants’ fee to £120 from the start of next year.
This would mean an increase of £44 on the current fee of £76, which has not risen since 2007.
The NMC council approved the proposed increase at its monthly meeting this morning, together with increases in line with inflation in future years.
The nursing regulator says the big increase is needed to finance the level of activity required to deliver its core fitness to practise functions.
Interim chief executive Jackie Smith told the council that the current fees generated around £51m a year of the regulator’s total income of £52m.
However, she warned that the NMC would need £73m this year to maintain the present level of FtP activity and that the regulator was “eating into” its financial reserves.
“What we’ve seen is an unprecedented increase in FtP activity,” she said.
The regulator current has a caseload of 4,461, up from 4,342 in March. It has also seen a 52% increase in referrals over the past two years while it continues to struggle with clearing a backlog of historic cases.
Without a fee rise, Ms Smith said the NMC would have to “immediately cut back its FtP activity”. The number of hearings would have to be reduced from 15 hearings per day to eight, which would result in 460 fewer a year. Ms Smith said this was not an option.
NMC interim chair Judith Ellis warned that the regulator’s financial position was “fundamentally unsustainable” without the fee increase. She added: “We have to be able to protect the public.”
The NMC said it planned to begin a consultation on the proposed fee increase next month.
Council was told that the regulator had discussed the move with health minister Anne Milton last Thursday. The Department of Health “know the facts of it,” said Professor Ellis.
Council member Ruth Sawtell said: “This is such a desperately worrying situation.”
“We are caught between a rock and a hard place.”
The regulator had discussed three fee level options: an increase of £100, and increase of £120 or an increase of £140.
The council notes said the lowest increase would “not sustain the FtP activity which is currently foreseen”, and was not discussed by members.
The £120 figure, which was recommended to the council and approved, would enable the NMC to deliver FtP and other regulatory activity at “safe levels”, the papers said.
Council member David Pyle also suggested that the fee increase in line with inflation in future years, to avoid a similar situation occurring again. This was also approved by council to be taken forward to the consultation.
Some council members favoured a fee rise of £140, which the papers said would “future proof” the regulator against unexpected hikes in referrals.
The NMC is predicting a further increase in activity following the publication of the Francis report into Mid Staffordshire Foundation Trust, which is due in the autumn.
Council member Grahame Owen said: “It is important to ask how much ‘headroom’ have we got with £120? It’s limited.”
But fellow member Carole Rees-Williams noted that any fee rise “might be difficult” for “nurses at the coalface” in the current economic climate.
Unison has told Nursing Times that it would be opposing any increase in the registration fee.
The union’s head of nursing, Gail Adams, said: “Hard pressed nurses and midwifes will rightly be very angry about plans to make them pay more to work.
“Many of these vital health workers and their families are already struggling to make ends meet. Not only have they had their pay frozen for two years, with two more years of pay austerity on the horizon, they are also having to pay more for their pensions.”
Royal College of Nursing chief executive and general secretary Peter Carter said: “This is a staggering proposal at a time when nurses are under huge financial pressure.
“Indeed, it is deeply unfair that the NMC would propose a near 60% hike in fees when nurses are in the middle of a two year pay freeze and facing increased pensions contributions. We know that the NMC is facing financial challenges, but nurses should not be picking up the tab.”
Both unions said they would be seeking an urgent meeting with the NMC on the issue.
Cathy Warwick, chief executive of the Royal College of Midwives, added: “I understand that high quality regulation of midwives and nurses comes at a price. However, the focus should not be on a fee rise but on the Government supporting the NMC to get its house in order, and to support it in dealing with the challenge of its fitness to practice caseload.
“Midwives should not face an increase and be the ones to pay the price for the current difficulties facing the NMC.”