Health and Care Professions Council: Registration Fees

Stephen Hammond Excerpts

Thursday 14th March 2019 Westminster Hall

[The Minister for Health (Stephen Hammond)]

It is a pleasure to serve under your chairmanship, Mr McCabe. Like everyone else, I congratulate the hon. Member for Coventry South (Mr Cunningham) on securing this debate. He made an impassioned speech that aired his campaign, which he has led with style and impact. The Health and Care Professions Council is one of nine UK-wide regulators. It performs an important role in the health and care sectors across all four countries of the UK, acting in patients’ and service users’ interest to ensure the professional standards we need to guarantee safety and quality.

Right at the start of my speech, I pay tribute to all the dedicated professionals who work in the professions governed by the HCPC. It is also right to respond to the Opposition spokesman, the hon. Member for Ellesmere Port and Neston (Justin Madders). He said, if I heard him correctly, that it was irresponsible of the Government not to intervene. There is an important point of principle here: the HCPC is independent of the Government. It is funded by registrants’ fees on a cost-recovery basis. It is therefore not the Government’s role to tell the HCPC what its fees should be. It is not a question of hiding or a lack of political will; it is a matter of law. As the hon. Gentleman knows, there is a mechanism for oversight of the HCPC, which is the Professional Standards Authority. It oversees the HCPC and its setting of fees.

It has been an excellent debate with lots of useful and informed contributions. I have been in a number of debates with the hon. Member for Strangford (Jim Shannon), and he spoke with his usual passion not only on behalf of the people of Strangford, but in the wider context as well. I want to pick up on what the hon. Member for Heywood and Middleton (Liz McInnes) said; I was listening carefully to her contribution. She is right that the vast majority of registrants have very little contact with the regulator between renewals of their registration. That may be a frustration and not seen as value for money, but from the other point of view, the HCPC’s largest expenditure is on delivering the fitness-to-practise function. It is therefore inevitable that it concentrates on the very small number of registrants whose performance or conduct has fallen below the expected level.

The key thing is the need for regulatory reform, which the hon. Member for Ellesmere Port and Neston was challenging me on a moment ago. We have recognised that regulators have inherited a complex and restrictive registration practice that is often bureaucratic and administratively burdensome. As he rightly pointed out, the four UK Governments consulted on proposals for reforming the legislative structure of professional regulation. That consultation finished last year.

The reforms that we are looking to make, and are still committed to, will shift the balance in professional regulation, freeing up the regulators to concentrate more on prevention and to work directly with registrants, rather than just on fitness to practise. I assure the hon. Gentleman that it is not our intention to hide that. We intend to bring it forward, and we will do so in the near future.

I was listening carefully to the hon. Member for York Central (Rachael Maskell). She made a point about the need for registration and also for the system to be updated. The Government are committed to that. I also listened carefully to the hon. Member for Blaydon (Liz Twist). She spoke with knowledge and mentioned a number of the fitness-to-practise cases she has been involved with. She was right to point out that the vast majority of those have been social care cases over a number of years. That brings me to a key point. A number of Members raised the issue of the HCPC’s costs potentially going down as a result of social workers moving out of that regulatory process. I have not looked at that in great depth, but it is highly likely that variable costs will decline for the HCPC. As a number of Members have pointed out, social workers make up the vast majority of the professions that are regulated—more than 25%—so there is an element of fixed costs. They are being helped by the establishment of Social Care England, and the costs are being met by the Government.

The HCPC currently regulates 16 professions. The hon. Members for Coventry South and for Ellesmere Port and Neston read out the list of professions, so I will not rehearse them all over again, but I reiterate my point: these valued professionals are performing crucial roles across the NHS and the wider health and care system. It is important that the public have assurance that those professionals are regulated. If they are regulated by the HCPC, the public knows that they are appropriately trained and hold the relevant qualifications, and that they meet the expected standards of conduct, performance and ethics. Where a professional falls below these standards, it is important that the HCPC is able to protect the interests of patients.

I take the point made by a number of hon. Members that the HCPC currently has the lowest registration fees of any UK-wide regulator in the health and care professions. It is clearly not right to look at that in comparison with some of the more highly paid professions, but it is true that the current annual registration is lower than that for a number of others, such as nurses and midwives. I also take the point that the proposal is for a large, one-off increase, but there has not been an increase for two years, and the registration fees are tax-deductible, so the increase will amount to about £1 a month.

A number of Members mentioned the disparity between the fees that are payable by part-time and full-time staff. I have listened carefully to that argument, and I will write to the HCPC to ask it to look at that more carefully. That seems to me to be a fair point.

A number of Members raised points about the consultation. The legislation that founded the HCPC required it to consult on any fee increase. Accordingly, it ran a public consultation, to which it received 2,396 responses. Some 95% of those responses were from professionals whom it regulates. It also engaged extensively with professional bodies, trade unions and other bodies ahead of and during its consultation. The draft response to the fees consultation was published with the HCPC’s council papers of 14 February. It is right that 90% of the respondents did not support a proposed fee rise.

However, it is fair to note that the majority of respondents also wanted HCPC to invest more in prevention and improved services, in increasing capacity, and in improving the quality and timeliness of the fitness-to-practise services that it delivers. Everybody accepts that no fee rise is popular, but the HCPC has been clear that the principal reason for this one is to allow it to deliver the services identified by registrants in the consultation.

[Dr Drew]

The Minister will have heard my earlier intervention. Will he assure us that he will ask for complete transparency and accountability, so that we know what the additional costs will go towards?

[Stephen Hammond]

I listened to the hon. Gentleman, and I will make a promise to him. As I pointed out at the beginning of my speech, it is not the Government’s role to tell the regulator how to set its fees or what to set them for. However, I see no reason why the Professional Standards Authority should not ask the HCPC to give that reassurance and to publish that information. I will write to the hon. Gentleman when I have spoken to the PSA to ensure that it can do that within its remit. Given that it has oversight, I am sure that that will be possible.

[Liz McInnes]

It is my understanding that the changes to the HCPC rules will be subject to parliamentary approval. The Minister says that the Government will not be able to have any influence, so by what mechanism will the rule change be approved by Parliament?

[Stephen Hammond]

On oversight of the fee change, there is effectively accountability to Parliament through an order of the Privy Council. The Government will need to introduce an order of the Privy Council, which will be subject to the negative resolution procedure. The financial oversight is done by the PSA. The Government have to lay the order, but the oversight is done via the Privy Council.

As I said, there has rightly been much discussion this afternoon about the reason for the proposed fee rise. The HCPC makes the point that it has not raised its fees since 2015. It also rightly makes the point that the vast bulk of the fee rise is for the services that its registrants want. I promised to write to the hon. Member for Stroud (Dr Drew) about that.

I thank the hon. Member for Coventry South for raising this issue. The debate has highlighted his campaign. I have no doubt that the HCPC and the PSA will have listened, and will take regard of this afternoon’s debate. I hope that my remarks, the promise I made to the hon. Member for Stroud, and my commitment to write to the HCPC will help the campaign of the hon. Member for Coventry South. I am clear that registrants should continue to benefit from a regulator that provides value for money and services to its registrants; I know that the PSA will ensure that they do so.