Health and Care Professions Council: Registration Fees

Rachael Maskell Excerpts

Thursday 14th March 2019 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under you in the Chair, Mr McCabe. I was also registered with the HCPC and the preceding bodies. Although I am no longer registered, I recognise the impact this issue has on NHS staff.

There are nine different regulators in the NHS, regulating 32 different professions. They provide a very important function: this is about protecting not only the public, but health professionals themselves in the course of their practice. The regulators are there to set, maintain and raise standards and to give confidence to the public, as well as to hold a register and protect the title of a profession, so that other people cannot set up a business pretending that they hold the professional qualifications, which people across the NHS work hard for.

Increasingly, regulators also ensure continuing professional development. The most advanced programme of professional development has been put in place by the Nursing and Midwifery Council in recent times. The regulations around that ensure that registrants are compliant with continuing professional development. The function of regulators is to ensure that professionals who fail to uphold professional standards and their duty of care are called to account, so that sanction is applied where necessary and recourse is taken.

We have already heard that—thankfully—a miniscule number of professionals are taken through disciplinary processes. That is a tribute to the great professionalism across the NHS. However, such cases do occur, and it is appropriate that rigorous processes are in place so that individuals can defend their position and have recourse to justice before appropriate action is taken. To have someone practising who is not fit for practice risks the whole profession, so it is vital that that is put in place.

However, the cost of that process has escalated substantially, as hon. Members have mentioned. When I first registered as a physio, I had to pay only £17. In 2015, the last year that I was registered, there was a huge increase—from £80 to £90. The suggested increase to £106 is, quite frankly, unacceptable, particularly given the background, as set out by hon. Members, of a decade of pay regression, pension cuts and student loan repayments. In my time we had grants, so things have changed significantly.

More and more burdens are being placed on health professionals. That means that more risk is placed on health professionals. When we had adequate staffing in the NHS, mistakes were less frequent and caseloads were safer. Unfortunately, in many professions people’s caseloads are now too big. The pressure on those individuals increases.

I was formerly head of health at Unite. We focused on organisations’ duty of care. Managers in particular must say no to the organisation and argue the case for more staff, rather than increase the pressure on health professionals by making their caseloads unsafe—that would mean that managers were failing in their duty of care, in breach of their standards of professional conduct.

[Mike Hill]

I am also a former Unison official. In view of that, does my hon. Friend agree that, as my hon. Friend the Member for Heywood and Middleton (Liz McInnes) rightly pointed out, the professional bodies cover not only full-time and part-time staff, but student social workers and student nurses? They are under the same constraints.

[Rachael Maskell]

Students do have responsibility, but the registered health professional is responsible for ensuring that they are safe under their practice while they are training in their profession. Training the future workforce is an incredibly important additional function of health professionals.

The Law Commission came forward with a set of recommendations for registrant bodies in 2012. In 2019, we still have not seen the implementation of those recommendations in full. I would like the Minister to explain why that is the case. Implementing a substantial piece of work about ensuring patient safety should surely be at the forefront of the Minister’s agenda. I am interested to hear the reasons for the delay, and what plans there are to put those recommendations in place. Training programmes for health professionals need to focus on the ethics, behaviour and conduct of health professionals, if we want to see a reduction in the number of cases. Managing that risk is really important.

I want to raise a number of points to move this case forward. First, as we have heard, 38,000 people signed a petition to register their discontent with the fee rise. That cannot be ignored. These are valuable NHS workers. Their call must be heard and reflected on. However, the HCPC hardly seems to have taken that into consideration. As my hon. Friend the Member for Heywood and Middleton (Liz McInnes) said, the number of fitness-to-practise cases being taken forward—currently, 59% of them involve social workers—will disappear. Therefore, surely the registrant body’s costs will decrease. We want to hear how that will benefit health professionals.

This is a tax on professionals. Will the Minister consider funding that regulation fee through the NHS? It does not make sense for nurses, physios and speech therapists, for example, to pay a different amount. That is a tax on professionals who have put in the training and the hours, and go over and above the hours. Why can the Government not pay the amount for each health professional? More than a gesture, it is a responsibility of the NHS to ensure that its registrants, including part-time workers, have that support. I completely concur with the suggestion made by my hon. Friend the Member for Heywood and Middleton that there should be a part-time rate.

[Dr Drew]

Forgive me if I am being simple, but do we know where the extra money is going and what the HCPC is doing with it? Can it explain that? Are the Government holding it accountable? Can my hon. Friend throw some light on that?

[Rachael Maskell]

My hon. Friend makes such a good point. I wish I could explain that, but to me it seems to be more money and less work. I am as baffled as he is about why health sector workers have to pay into this institution to do less work. I worked as a part-timer when I was head of health at Unite. Although I worked at weekends, I had to pay the full fee, so I certainly understand the frustration. Of course, that mainly affects women, who are more likely to work part time.

Finally, I ask that an expansion of the number of registered health professionals should be considered—after all, this is about keeping the public safe. We should know that the title under which the professional acts is secure and represents them. Certainly psychological services, such as psychotherapists, have requested to be registered, as have community nursery nurses. It is perplexing that the registration of nursing associates on a register—not this one—has been accelerated, but the registration of community nursery nurses, who have long asked for that, has not happened.

I would go further and say that, as we are looking at the future of the social care workforce across the country, we should also look at individuals who are singlehandedly going into people’s homes but who do not have the protection of being on a professional register. Ultimately, that is about keeping the public and our health professionals safe and secure. What steps is the Minister taking to ensure that a greater number of professionals are protected under the existing regulatory regimes?