Health Professionals Council (Registration and Fees) Rules Order of Council 2003

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The Chairman: It is a passing interest.

Mr. Hutton: I am sure that it is a keen interest. Given that rival attraction, it might be better if I confine my remarks to fees, which the hon. Member for Sutton and Cheam raised a number of concerns about and asked me to comment on. It is clear that registrant fee income is the main source of income on which the Health Professions Council must rely, so the fees that it sets must reflect the actual cost of providing a comprehensive regulatory function. It is also the means by which professionals themselves secure a direct role in determining their professional training and practice standards.

The hon. Member for Sutton and Cheam is right to say that the council has set the annual registration fee at £60, and that is reflected in the rules. It has done so after taking into account the many comments that it received from registrants and others during the recent consultation exercise. As he rightly said, it had proposed raising the fees to between £65 and £85 a year. I acknowledge that £60 is a considerable increase on the previous fee of £22 a year. However, it is worth saying that, compared with the fee charged by other health care regulators, it is still very small. Those other fees range from £20 a year to more than £1,000 a year paid by chiropractors. Only one other regulator charges less, and that is the Nursing and Midwifery Council. It is able to reduce its costs for individuals by virtue of its exceptionally large number of registrants, which is three times the number covered by the Health Professions Council. The NMC and the HPC are the only two organisations that are able to hold down fees to well below £100 a year.

The council has explained its reasons for the increase. On its establishment, it inherited debt from its predecessor. It had insufficient reserves to give it a solid financial basis, so it has had to operate a deficit budget for the first two years of its existence, which is clearly not acceptable. That is despite transitional funding of about £4.5 million from my Department to help fund the setting up of new systems and some essential building work at the council's offices to accommodate the increased scale of its operations.

The council has drawn up a five-year plan based on known and forecast activity and expenditure. The fees that it charges reflect the minimum needed to cover that increased activity. About £2 per registrant a year over five years to 2007-08, the end of the five-year planning sequence, will allow the council to build up nearly £2 million in reserves. That is just over half its annual running costs and is the minimum that it considers necessary to keep the organisation financially viable and to provide working capital. Those judgments are sound.

The council's five-year plan shows that it is taking its financial responsibilities seriously. Turnover is set to increase significantly, from £4.5 million this year to

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nearly £14 million a year by 2008. That reflects the much greater responsibilities that the council now has compared with its predecessor. The hon. Member for Sutton and Cheam asked me how the extra increase was justified, and I think that I have explained it. Within that, the way in which the resources are applied will change greatly, with only half the proportion currently spent on staff and buildings, and only a third of what is now spent on the council and its sub-committees. Most of the fee increase will be put to use on the areas that will directly benefit both patients and registrants.

I wish to make two final points about the £60 fee. There are ways of minimising the burden for registrants by spreading payment at the rate of £30 each six months by direct debit. The council intends to offer such a facility. The fees are deductible against income tax, which will help to reduce the real level of professional fees payable to the Health Professions Council to £47 a year for standard rate taxpayers.

We need to be clear about the consequences of not approving the rules and of trying to force the council to set fees at a lower level. Reducing the fee to, say, £59 a year would mean that the council would take a further year to start building up its reserves. We should not do that. Reducing the fee to £55 would mean that, by 2008, it would still be operating at a deficit of more than £500.000. That is not acceptable either. It would inevitably mean that it would have to raise fees again, sooner and higher than it would otherwise have had to do.

The Health Professions Council is intending to keep the fees at the current levels specified in the order for the next five years. Although the increase may be unpalatable to some registrants, with whose legitimate concerns I have sympathy, it will set the council on a proper financial footing that will help to avoid large increases in the future, which would not be in the interests of the profession or the council. That is the right course of action, and I hope that all members of the Committee will support the difficult decisions that the council has felt it necessary to make.

The rules are a sensible and practical piece of legislation, designed to provide a workable system of regulation for health professions whose work is at the forefront of patient care. I commend the order to the Committee.

2.49 pm

Mr. John Baron (Billericay): It smacks of hypocrisy when the Liberal Democrats say that they are supporting the HPC, given that they voted against it a couple of years ago.

Mr. Hutton: I hate to correct the hon. Gentleman when he has only just got going, but the Liberal Democrats abstained—his party voted against the HPC.

Mr. Baron: I take the point, but the bottom line is that, overall, we were supportive of the establishment of the body and what the Government were trying to achieve. We believe that the 2001 order is useful legislation for a variety of reasons. One is that what

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existed for 30 years before the establishment of the body was totally unacceptable. Indeed, the health professions themselves wanted tighter regulation. It was also all about protecting the patient.

It is understandable that the fees have gone up. I respectfully point out that following the 2001 order legislation has changed enormously and much more will have to be done, for example, in communicating with the public and letting them know what the HPC is, what it does, how to contact it and the boundaries of responsibility. The planned increase in fitness-to-practise hearings should be considered, as should the fact that now, as I understand it, the HPC will legally have to compensate council members.

I have a numbers of questions for the Minister regarding Opposition Members' specific concerns about the establishment of the register. If he cannot respond immediately, I will be happy to receive answers in writing. The organisation opened its new register on 9 July 2003, following the closure of the Council for Professions Supplementary to Medicine system to UK applicants on 27 June. Why was there a 12-day gap between the closure of the old register and the establishment of the new one? In addition, what has happened to those applicants who submitted applications on the dates when there was no register? Can the Minister confirm that no applications have been lost as a result of the gap between the two registers?

On the part of the order entitled ''The Register'', can the Minister clarify what personal information, if any, will be entered on the published register? Where will the published register be kept, and how and to whom will it be available? If health professionals registered with the HPC and working in the UK decide to work overseas temporarily, how will this affect their registration?

Rule 7 states that

    ''an applicant who is not an EEA national''

may have to produce evidence that he or she has

    ''sufficient knowledge of spoken and written English''

to enable him or her to carry out his or her professional duties. Can the Minister explain what mechanisms are in place to ensure that European Economic Area nationals have such proficiency in the English language?

Finally, how has the HPC worked to ensure that form filling and paperwork are kept to a minimum? The Conservative party always believes that it is important to try to reduce unnecessary red tape and paperwork. I put it to the Minister that this Government have a bad record on keeping form filling to a minimum. We know that, in primary care, doctors have complained about the increasing amount of red tape and paperwork. The recent GP vacancy rates highlight just how difficult it is to attract individuals to that profession, so I hope that the Minister will accept that we do not want to hear similar pleas from the health professionals. I look forward to hearing his response to my questions.

<<10>>2.54 pm

Mr. Hutton: I shall probably take up the hon. Gentleman's invitation to write to him about some of the issues that he raised at the beginning of his remarks, because I do not want to detain the Committee with them and I have no ministerial responsibility for them. They are operational matters for the Health Professions Council, but I will arrange for him to receive detailed answers to his questions, because they are perfectly fair and reasonable.

The hon. Gentleman's third group of questions concerned what details need to be on the register. The order makes it clear that the council is required to publish information about its registrants to help people to check whether a health professional whom they may be treated by, or whom they may wish to employ, is on the register, and to discover what they are competent to do. The council has tried to follow established practice on what registrant details will appear. We do not want to compromise people's safety or security by publishing their home address, unless they are happy for that information to appear on the register; indeed, rule 3(2) deals with precisely that point. The council has tried to strike a balance. A public register should be a device fit for its created purpose: it should allow employers and the public to check the key details of, and data on, a registrant. Most of the information on that matter is set out in the order.

I did hope that copies of the various forms that the rules give effect to would be available today, but I see from looking at the Table that we have not managed to provide them. I will share the details of those forms with the hon. Member for Billericay (Mr. Baron), with whom I agree about the need to minimise bureaucracy. [Interruption.] Ah, I see that the forms are indeed on the Table, so he can have a look at them. On doing so myself, I thought them a model of good practice. They are easy to read and complete, and the council should be congratulated on that.

I shall not get into an argument with the hon. Gentleman about the number of doctors working in primary care, because this is neither the time nor the place to do so. I shall simply say that there are more GPs than ever before, and that we are training and recruiting more for primary care.

It is right that an effective system should be in place to ensure that health professionals are competent in and fluent in English; otherwise, they will struggle to provide an effective service for their patients and clients. In the first instance, the position regarding EEA nationals is regulated by the treaty obligations and commitments arising from our membership of the European Union. For non-EEA nationals, the rules provide for the establishment of an English competency test. The hon. Gentleman asked about the arrangements in place for EEA nationals. That is a matter not for the Health Professions Council, but for individual employers who wish to recruit health professionals from those countries. They set a variety of tests and need to satisfy themselves about fluency and competency. That is permitted, but under the

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European framework of legislation for regulatory bodies, setting English competency requirements for EEA nationals is not.

I have in front of me a reference to another point made by the hon. Gentleman, but it is blurred and I do not know what it is. That is my problem, and if I have not answered all the points that he raised, I am happy to follow them up in writing.

Mr. Burstow: I thank the Minister for his answers to my inquiries, and those of the hon. Member for Billericay; I particularly enjoyed his helpful

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intervention on the hon. Gentleman. We do not wish to detain the Committee further, but it has been useful to raise these points, some of which will probably be returned to through questions.

Question put and agreed to.


    That the Committee has considered the Health Professions Council (Registration and Fees) Rules Order of Council 2003 (S.I. 2003, No. 1572).

        Committee rose at two minutes to Three o'clock.

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The following Members attended the Committee:
Atkinson, Mr. Peter (Chairman)
Baron, Mr.
Burstow, Mr.
Calton, Mrs.
Hesford, Stephen
Hutton, Mr.

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Jones, Lynne
McKenna, Rosemary
Ross, Mr.
Ryan, Joan
Singh, Mr.
Taylor, Ms Dari
Ward, Claire

The following Member also attended, pursuant to Standing Order No. 118(2):

Gerrard, Mr. Neil (Walthamstow)

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Prepared 29 October 2003