NT unearthed evidence of six-figure pay-offs to employees and of Nursing and Midwifery Council members writing directly to ministers at the Department of Health to voice their concerns about the structure of the regulator (NT News, 28 February, p3).
Livingstone MP Jim Devine, a former psychiatric nurse, raised these issues in parliament in February, and subsequently tabled 11 questions to ministers about the regulator.
The Charity Commission – the NMC has charitable status – also confirmed to NT this month that it had been notified of concerns about the regulator, and was considering whether to investigate them.
But last week there was a step-change in events. Mr Devine made public full details of allegations made against the NMC in a half-hour adjournment debate in the Commons. The allegations, as yet unproven and strongly denied by the council, are serious.
He said the NMC appeared to be ‘fundamentally dysfunctional’, with an ‘ingrained culture of bullying and racism’.
‘The culture at the NMC is reflected by the fact that some 20 complaints and counter-complaints have been filed in the past year against eight current and two previous members of the council, and I understand that there are more complaints in the pipeline,’ he said.
Legal expenditure on governance issues and costs relating to investigating complaints from council members seeking explanations were ‘well over’ £120,000 in 2007, Mr Devine told MPs. This year, he said expenditure could be in the region of £300,000 – the equivalent of the £76 registration fees of nearly 4,000 nurses.
‘Staff whose faces do not fit are subject to disciplinary action, paid off and required to sign confidentiality agreements,’ he added. As NT has previously revealed, two such payments were worth more than £100,000 each.
Mr Devine said: ‘As a self-governing regulator, whose purposes are public protection and the public interest, the NMC should be run with integrity, competence and transparency. Unfortunately, that appears not to be the case.
‘It appears to be a fundamentally dysfunctional organisation where the priority of those in control is to maintain the status quo at the expense of proper transparency and good governance. Its funds are being misspent and staff time is being misused,’ he said.
Dr Richard Taylor, MP for Wyre Forest and a member of the health select committee, added that he too had been approached with ‘very serious allegations about probity and conduct’ at the NMC.
But worse was to follow, as Mr Devine went on the read out six anonymous statements from ‘whistleblowers’ at every level of the organisation, including former staff, former members, and both current and former council members.
A union representative, who was also quoted, described the NMC as ‘dysfunctional’ and ‘out of control’, and that ‘it is not just the staff but council members are being harassed and bullied’.
Staff who have raised grievances about the way the NMC is run have been investigated by the individuals they have raised concerns about, the statement added.
A statement from a former council member said funds – raised from nurses’ registration fees – had been misspent and trustees prevented from doing their jobs. A second council member statement warned that current members were scared of incrimination, bullying and harassment.
However, a third statement, from a former member of staff, said: ‘The changes made to the culture of the organisation resulted in a very unpleasant, punitive and negative working environment lacking transparency. Sarah [Thewlis] held what she termed “soft chair conversations” with staff who were not in favour. This involved me being given at one point what she termed a bollocking.'
The issues facing the NMC come at a time when the future of self-regulation of health professionals is already under review via the White Paper ‘Trust, Assurance and Safety’.
However, the government has no power to intervene directly in the regulator’s internal operations at present because the NMC is as an independent professional regulatory body. But the public airing of such sensitive allegations has forced ministers to respond.
Health minister Ben Bradshaw told MPs he would be writing to the healthcare super-regulator, the Council for Healthcare Regulatory Excellence, and the Charity Commission to ‘encourage’ them to investigate Mr Devine’s claims.
If these investigations did not resolve the problems, Mr Bradshaw said he would call for the Privy Council, which the NMC is accountable to, to intervene – a step he described as the ‘nuclear option’ and that would probably result in a public inquiry.
‘It important to me as well as to thousands of nurses and midwives that the workings of the NMC and all regulators should be open and transparent. That is crucial to maintaining patient and public confidence,’ Mr Bradshaw said.
The NMC, for its part, has launched an internal inquiry into the criticisms and has robustly denied the accusations since they were first made public.
Ms Thewlis declined an invitation from NT to comment personally. However, the NMC has produced a statement defending its record on governance and financial management.
‘The NMC’s workforce is extremely diverse, highly competent and committed to delivering excellence in regulation and public protection and will continue to do so,’ it said.
Regarding its financial management, the regulator reiterated its position that the recent fee increases were needed to pay off a debt inherited from its predecessor, the UKCC, which it replaced in 2002.
The organisation’s debt is set to be reduced from £7.6m at the end of the last financial year to around £1.6m this year, a spokesperson added.
‘To date, all of the allegations regarding the NMC have been made either under parliamentary privilege or to the media,’ the statement went on to say. ‘We are disappointed that none of the individuals who have made these allegations have chosen to approach the NMC.’
However, the regulator claimed that it welcomed the investigations by the CHRE and Charity Commission. ‘Independent scrutiny will give us a chance to demonstrate that the NMC is a fully accountable, open and transparent organisation which does no tolerate discrimination of any kind,’ it said.
Whatever the outcome of the various inquiries, nurses will undoubtedly be disturbed at the allegations made by Mr Devine about the body charged with regulating their fitness to practice.
‘It’s vital that public confidence is restored in the NMC as soon as possible,’ Unison, the RCN and Unite said in a joint statement.
Nursing Times would like to hear your views on this story. Click here to contribute to our online forum.