Health and Care Professions Council: Registration Fees

Brendan O'Hara Excerpts

Thursday 14th March 2019 Westminster Hall

[Brendan O'Hara (Argyll and Bute) (SNP)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I, too, congratulate the hon. Member for Coventry South (Mr Cunningham) on securing this important debate and highlighting the issue. If it were not for him and one or two other hon. Members, the change might have gone largely unnoticed, except by those adversely affected by it. I sincerely hope that it now gets the attention that it so deserves.

As hon. Members will know, the overwhelming majority of health and care matters involving Scotland are devolved to the Scottish Parliament. However, most of the system of regulation of health and care professionals still operates at a UK-wide level. That is because in 2010 the Calman Commission on Scottish Devolution felt that those bodies that dealt with professional regulation of practitioners would best operate at a UK level. The commission’s rationale was that that would provide clarity and assurance to patients that there was a common approach and a common set of standards right across the UK, and that it would also help to facilitate the mobility of professionals who chose to move between the nations of the United Kingdom.

The one exception to that was, of course, social work; Scotland, Wales and Northern Ireland had their own professional bodies in place alongside the Health and Care Professionals Council, which represented social workers in England. Together, those bodies worked on a four-council basis across the UK, and had a memorandum of understanding that set out a framework for close working. As I understand it, part of the problem is that the HCPC is about to lose around 90,000 social workers in England to a new professional body—an issue to which I will return shortly.

Professional registration fees for social workers is a devolved matter; it was devolved in 2003, and the fees remained static until 2016. It goes without saying that the Scottish Government would welcome further devolution of such powers to Scotland, so that we can ensure that any planned changes to that regime are better tailored to the needs of health and care practitioners in Scotland.

As for the issue before us, the Scottish Government are on record as saying that they are more than a little surprised and confused as to why an 18% hike in fees was deemed necessary or appropriate. They seek clarification from the HCPC on how such a substantial jump, which is so out of line with inflation, could possibly be justified. In addition, they are seeking reassurances from the HCPC that it is not simply attempting to make up any projected loss in revenue as a result of the departure of social workers in England by hiking up membership registration fees.

As the hon. Member for Coventry South said, being a member of the HCPC is not an optional extra; people cannot opt out of it and still practise their profession. As the HCPC has a captive market, any price increase must be seen as fair and proportionate, and the practitioners who pay that increased fee must know why they are being forced to pay it, and what benefits it will bring to them and to the profession as a whole. As I understand it, the Scottish Government have contacted, or will contact, the HCPC to get a clearer understanding of its motivation, both in the short and the long term.

As has been pointed out by just about every speaker, this 18% rise in fees hugely outstrips inflation. Given the real-terms cuts that many health and care staff have experienced in recent years, that is another financial blow that they could do without.

In addition, as the HCPC insists on charging a flat rate, if the rise in fees goes ahead as planned, it will of course have a disproportionate effect on part-time workers, who are mainly women, and those workers who are considering reducing, or want to reduce, their working hours. I repeat the Scottish Government’s call for all workers to be paid the real living wage, which better reflects the cost of living and inflation. I am proud that Scotland has the highest proportion of employees earning the real living wage of any nation of the UK.

The contributions to this excellent debate have had a common theme. Regarding the hon. Member for Strangford (Jim Shannon), it beggars belief that anyone in his constituency could be unaware of how hard he works. I used to wonder how he did so much in this place, and I have concluded that he is one of triplets. His valuable contribution today, which compared the pay rise for NHS workers with the rise in professional fees being asked by the HCPC, was very telling.

The hon. Member for Heywood and Middleton (Liz McInnes) brought a much-needed voice from the shop floor or the coalface to this debate, and I am very grateful to her for sharing her experience. It is that experience, and her credibility, that demand that she be listened to by the people making this decision.

Similarly, the hon. Member for York Central (Rachael Maskell), another former healthcare professional, gave a personal account of paying £17—I think that is what she said—at the beginning of her career, and compared that with the £106 fee being proposed. That really gave this debate context.

I thank the hon. Member for Blaydon (Liz Twist) for sharing the personal experiences of her family, who have been supported by a dedicated professional. I guarantee that that dedicated professional will not earn a great deal; for them, this increase will be a significant amount of money. I thank all the hon. Members who have spoken for their contributions this afternoon.

If this proposed 18% increase goes ahead, HCPC fees will have risen by 40% since 2014. That is a remarkable figure by any standard, and it is easy to see why the unions and others view it as excessive, unreasonable and unjustified. I put on the record my thanks to Unison for its enormous help in briefing Members of Parliament. I cannot think why the HCPC did not take advantage of this opportunity to brief Members as well; it seems to be entrenched somewhere and does not wish to engage. It had an opportunity to put its case and let Members understand in greater detail its rationale for this increase.

I cannot help but think that at a time when the NHS is struggling with staff shortages in many areas, this decision could have a negative impact on key parts of its workforce. The arbitrary way in which this increase seems to have been arrived at, and the lack of any adequate mechanism to prevent such an arbitrary rise, is seriously problematic.

A consultation opened in September last year. The consultation document put out by the HCPC referred to: improving capacity and services around fitness to practise; keeping pace with inflation, although perhaps the HCPC is talking about Venezuelan inflation, because this increase seems wildly out of line with inflation here; and the costs associated with the impending transfer of social workers in England to their own professional regulatory body. I think that last part is the key to this situation. There is an overwhelming sense that the HCPC is chasing money that it fears it will lose as a result of this reorganisation.

I am not naive; I understand that folk do not normally vote for price rises. However, the fact that 90% of respondents were opposed to the rise should cause concern, yet the HCPC is pressing ahead regardless with its decision to implement this rise in fees. When Unison asked about the increase, 99% of respondents opposed it, and 76% said that they did not believe that they were getting good value for money as things were, which shows that the HCPC has a problem.

As we have heard many times—indeed, I have referred to this myself—the change in the regulation of social workers in England is the key to this situation. However, I call on the HCPC to pause before implementing this decision to increase fees. It should seriously consider why its members are so implacably opposed to it. Can it seriously justify asking its remaining members to pick up the slack resulting from the loss of social workers in England to a new professional body? I do not think it can. During that pause, perhaps it could examine further ways of increasing its revenue, rather than continuing on the road that it is on.

I finish by once again thanking the hon. Member for Coventry South for bringing this matter to our attention, and for securing this ever so important debate.