Health and Care Professions Council: Registration Fees

Debate between David Drew and Liz McInnes

Thursday 14th March 2019 Westminster Hall

[Liz McInnes (Heywood and Middleton) (Lab)]

It is a pleasure to serve under your chairmanship, Mr McCabe. I am grateful to my hon. Friend the Member for Coventry South (Mr Cunningham) for securing this important debate. I, too, had requested a debate on this subject but was unsuccessful, so I am pleased that he has been able to bring this important issue to the attention of the House.

Before I was elected to this place, I was registered with the Health and Care Professions Council, because I worked as a clinical scientist in the NHS. As we have heard, registration with the HCPC is an essential part of the job: without professional registration, scientists and allied health professionals in the NHS are not allowed to practise. I am no longer registered with the HCPC. Having worked for the NHS for 33 years and had a career change late in my working life, I have called time on my NHS career, so there is no conflict of interest.

The HCPC charging above-inflation fee increases is nothing new, but it is scandalous that its latest proposal is to raise fees for already hard-pressed healthcare professionals by an enormous inflating-busting 18%. If that increase is imposed, HCPC fees will have risen by 40% since 2014, outstripping inflation and going hugely above any pay rises that NHS staff have had.

I remember from my days in the NHS that the HCPC used to impose above-inflation fee increases during the years of the George Osborne 1% public sector pay cap. Any representations that the staff and trade unions made to the HCPC, at a time when many staff had had no pay rise at all, fell on deaf ears and were simply ignored. It appears that that has emboldened the HCPC to ask for more and more from its members, with no discernible improvement in the performance of the HCPC or an increase in the services that it provides to its registrants.

NHS staff are already struggling, their pay having been suppressed for many years since 2010, but more and more financial demands are made on them in order to stay in work. NHS staff in England have to pay to park at their workplace; NHS staff are paying more towards their pensions; any member of staff with any sense will be paying trade union subscriptions; many are repaying student loans; and now, they appear to be expected to finance the HCPC’s excessive, unreasonable and unjustified fee demands.

The staff are just not being listened to. My trade union, Unite, submitted a 38,000-signature petition against the fee increase to the chief executive of the HCPC before the decision was made on 14 February this year to increase its mandatory fees by 18%. It appears that the HCPC is quite happy to blithely ignore the voices of 38,000 of its members. Additionally, the HCPC consulted on increasing its fees from £90 to £106 a year and 90% of those who responded disagreed, yet that seems to have had no impact on the decision made on 14 February.

[Dr David Drew (Stroud) (Lab/Co-op)]

Does my hon. Friend agree with me—she is making this case anyway—about how unaccountable this body is? I have dealt with individuals who have fallen foul of it and I have written to it on their behalf, but it appears to take no notice at all of what an individual MP or constituent has to say.

[Liz McInnes]

I do agree, and I thank my hon. Friend for that intervention. I should add that while I worked for the NHS, I was a trade union rep for Unite the union and had many encounters with the HCPC. I found it to be opaque in its dealings and difficult to deal with.

I want to mention the effect of the fee increase on part-time workers, because scandalously there is no difference in fees between full-time and part-time workers, so it will have a disproportionate effect on part-time workers, who in the NHS are predominantly female.

If we look at what the HCPC actually does, we find, from its 2018 annual report, that it dealt with complaints against only 0.64% of registrants and that it sanctioned only 0.09%. Many members comment that they receive no benefit or professional services at all from their registration. As we have just discussed, the HCPC operates in a very opaque manner. Trade unions are not recognised within its own workforce, so there is no collective pay bargaining for its own employees, and so we do not even know what the HCPC pays its staff.

The HCPC says that it needs this increase so that it can deliver smarter regulation, improve services and mitigate the impact of the transfer of the regulation of social workers to Social Work England. However, I have already talked about how few fitness-to-practise cases the HCPC deals with as a proportion of the total membership. When social worker regulation moves to a new regulator later this year, that should lead to a reduction in fitness-to-practise expenditure, given that 59% of that expenditure currently goes on social work cases. The HCPC’s costs should decrease, not increase, which makes this demand on registrants even more unjustified.

This is Healthcare Science Week and I pay tribute to all the scientists working across our NHS. Their work quite often goes unrecognised, but is an essential component of the diagnosis and treatment of disease. Healthcare scientists and allied health professionals are a vital part of our NHS team.

In conclusion, I call on the HCPC to pause, to delay any decision to increase fees, and instead to explore alternative ways to reduce costs and to fully assess the impact of the transfer of social workers.

Hospice Funding and the NHS Pay Award

Debate between David Drew and Liz McInnes

Wednesday 31st October 2018 Westminster Hall

[Liz McInnes]

The right hon. Gentleman is absolutely right. I will explore the Agenda for Change later, because adopting it presents huge difficulties for non-NHS organisations.

The three points from the chief executive of Springhill Hospice were tabled as parliamentary questions. Sadly they received identical answers that included:

“We are considering carefully the impact of any agreement on non-NHS organisations such as hospices that may be affected by the proposed pay deal; however no decisions have been made. Staff in hospices do a fantastic job in delivering world-class care and the Department remains fully committed to improving palliative and end of life care.”

In July, I wrote to the Secretary of State for Health and Social Care, asking for an update on the issue. The response stated that he “understood concerns” that

“hospices may find recruitment and retention challenging if some of their staff choose to leave in favour of organisations that employ staff on the Agenda for Change contract”.

In summary, the Government will finance the pay award for non-statutory, non-NHS organisations only for organisations employing staff on the Agenda for Change contract, which is the nationally agreed set of terms and conditions for most NHS staff. The rationale for that was that:

“Additional funding relies on organisations employing staff on the Agenda for Change contract, because it is the Agenda for Change pay and non-pay reforms that together will help deliver the productivity improvements the Chancellor asked for in return for additional pay investment”.

What are the reforms that can only be made under Agenda for Change? On examination, it seems to be an emphasis on training and apprenticeships and a programme of appraisal and personal development. There is also a slightly vague statement on the improvement of the health and wellbeing of NHS staff, to improve levels of attendance, with a reference to

“positive management of sickness absence”,

whatever that may mean.

The response from Springhill Hospice was grim. The chief executive wrote to me:

“Very few charitable hospices employ their staff on Agenda for Change contracts, and as a result, Springhill Hospice, along with many other hospices, will miss out on the funding being set aside by the Government. This will place us at a considerable disadvantage in recruiting and retaining essential staff to deliver the services that we offer to people with life-limiting illness in this community, and will leave us with a significant additional cost.

Recruiting and retaining skilled staff is a critical challenge for us, and in order to remain competitive, we will have little choice but to increase pay for clinical staff. Over the course of the three-year NHS pay deal, we estimate that this will bring an additional cost to the hospice of in excess of £250,000. Without support from the Government, this extra cost can only be met by asking our communities to give more, or by reducing the services that we provide.

We are already asking our community for in excess of £2 million contribution each and every year, and in an area of high deprivation, I can only envisage that any additional ‘ask’ will not be able to be met by our community, so sadly we may have to look at service reduction, which in turn will place additional burden on an already stretched NHS.

NHS staff will start to see the pay increase reflected in their pay packets from this month onwards. Without government support, Springhill Hospice will see a significant additional cost fall to the charity as a consequence.”

[Dr David Drew (Stroud) (Lab/Co-op)]

My hon. Friend is being very generous with her time. Does she agree that one problem, shared by Longfield Hospice in my constituency, is the opaqueness about the money that the NHS puts into the hospice movement? It does not put much in, and it is unclear why it comes and what it should be used for.

[Liz McInnes]

I certainly agree with my hon. Friend. While preparing for the debate, I tried and failed to get clarity on how NHS funding is allocated to hospice services. I hope that the Minister will provide some clarity on that.

The chief executive of Springhill said that the Department’s response was unhelpful, and that if the hospice were to utilise Agenda for Change terms and conditions in full, it would have to go through a massive consultation with staff and would need to change everyone’s terms and conditions of employment, assuming that there was buy-in through the consultation process. In addition, it would have to employ a very bureaucratic appraisal system—it already has robust appraisal processes in place—while adopting the Agenda for Change process would necessitate a massive investment in staff training, which would again add to the cost burden.