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Nurses are entitled to be angered by the Nursing and Midwifery Council's decision to increase the re-registration fees from £76 to £100 a year. Not only does it come in the midst of a protracted pay freeze, but there is scant evidence that pumping more money into the regulator's coffers will do anything to enhance public protection.
None of the systems in place to oversee nurse regulation over the past quarter of a century have been effective. The NMC's predecessor had a large, unwieldy, elected council that struggled to build consensus. In its dying days it turned a blind eye to a stock market crash that left the NMC to inherit a huge financial deficit.
The NMC has been in existence for barely a decade, but has succeeded only in staggering from one crisis to another. Council members were appointed at first, then elected, and now are being appointed again. At the top there has been a revolving door that has seen various chairs and chief executives brought in, forced out, persuaded to stay, and leave at short notice.
Re-registration fees have gone up 733 per cent, from £12 a year to £100, since 2001. Yet nurses accused of being unfi t to practise have to wait ever longer for justice and there is no sign yet of a robust system of revalidation to replace PREP. Registrants are left to pay for an inefficient bureaucracy that is not fit for purpose, and patients' groups can argue with some justification that they are not obtaining the protection they are supposed to receive.
The original concept of the NMC and similar bodies was that they facilitated professional self-regulation, but this no longer holds. No one who took last week's decision to ramp up re-registration fees is accountable to the people who have to find the money.
The Department of Health's £20 million bail out was welcome, and not only because it reduced the scale of the fees increase. It also established a principle that the taxpayer should make a contribution to the NMC's running costs, and means ministers will take an interest in how this slice of public money is spent. But the NMC has a long way to go before it will enjoy the confidence of the nurses it regulates.
Editorial | October 31 2012 | Vol 27 no 9
Nursing Standard is published every Wednesday by RCN Publishing Company Ltd, the publishing company of the Royal College of Nursing.
It seeks to promote professional excellence, and encourage creativity and innovation in nursing, midwifery and health visiting practice. Nursing Standard also aims to enhance nurses' and healthcare assistants' career development and to help them achieve and maintain a healthy and rewarding working environment. Nursing Standard is editorially independent and the opinions expressed are not those of the RCN or of the contributor's employing organisation unless specifically stated.