Health and Care Professions Council (Registration and Fees) (Amendment) (No 2) Rules Order of Council 2015 (SI 2015/1337)
Agenda item 4 is consideration of a negative statutory instrument, namely the Health and Care Professions Council (Registration and Fees) (Amendment) (No 2) Rules Order of Council 2015 (SI 2015/1337).
The Delegated Powers and Law Reform Committee has not made any comments on the instrument. Dr Richard Simpson has lodged a motion—S4M-13509—asking that the committee annul the instrument. As a consequence, we will hear evidence from the Health and Care Professions Council and from Unison, and then from the Minister for Sport, Health Improvement and Mental Health and his officials. After we have had answers to all our questions, we will have a formal debate on the motion.
I welcome to the committee Marc Seale, chief executive and registrar, Health and Care Professions Council, and Dave Watson, Scottish organiser (bargaining and campaigns), Unison. We will move directly to questions. I invite questions from members.
10:30
I appreciate that the rise in fees has been forced on the Health and Care Professions Council because of the Government withdrawing funds from the Professional Standards Authority, with the result that there is a levy on all the subsidiary groups—the General Medical Council, the Nursing and Midwifery Council and the rest, including your organisation.
However, it is my understanding that, given that you have 329,000-odd members, an increase of about £3 would have been necessary to pay for that levy. If that is correct, I fail to understand why, at a time of austerity and pay freeze, you are asking workers to meet an increase in fees of roughly 12 per cent across the board. Would you like to tell us how you came to that conclusion? What were your reasons? Why does that increase follow a 5 per cent increase in the previous year, which I understood was to last for at least two years?
The PSA levy is not the only driver for putting up the fees. We also need to ensure that we deliver our statutory duty to protect the public, and we want to remain an efficient and effective regulator. We are having to make investments and spend money in three areas. First, we are putting a considerable amount of money into our information technology systems to make sure that we remain an effective regulator. Secondly, we need to continue to put increasing resources into the fitness-to-practise process—the disciplinary process. We are dealing with more cases and they are becoming more complex. Thirdly, we have to fund the PSA levy.
As an organisation, we cannot just put up our fees and the money will come in on day 1. We have 16 professions, and we renew them over a two-year period. If we were to put up the fees today, the last fee for the last registrant would increase in one year and 364 days. Therefore, we need to put that money up so that we can pay for the costs of being a regulator.
We have always had the attitude that we should be efficient and effective, wherever possible, and you will see from our submission that, compared with the fees of the other regulators, we remain firmly at the bottom of the table. We think that that is very good. We are acutely aware that many of the professionals whom we regulate have no choice—they have to be on our register—and we are acutely aware that we must be very careful in how we spend money and that we must keep ourselves at the bottom of the costs table compared with the other regulators.
I will correct one fact—you are not the body with the lowest fees. The body with the lowest fees is the Scottish body for the registration of social workers—the Scottish Social Services Council. Its fee is not £80 or your proposed fee of £90. Its fee is £30 and, for some, it is £20 or £15. I question the efficiency of the Health and Care Professions Council when it will cost social workers in England three times as much as it costs social workers in Scotland to register.
Why on earth is the HCPC based in London? What possible reason is there for being in the most expensive centre in the United Kingdom? Why is it not based in Birmingham, Newcastle, Leeds, Sheffield or even Edinburgh or Glasgow? I cannot see why such organisations should be based in London. In relation to your statement about efficiency, will you explain why you have not sought to move out of London? I know that you are seeking new premises for your fitness-to-practise process. From reading your submission, I know that you have concerns about your ability to provide proper facilities for your fitness-to-practise hearings, so you are to expand into other premises. Why on earth are you based in London?
To deal with your first point, I was making a comparison with the nine UK-wide regulators that are under the auspices of the PSA. We are the lowest-cost regulator of those nine organisations. Other regulators in the rest of the UK—those in Northern Ireland, Wales and Scotland, for example—are not independent; they are arm’s-length bodies. The roles of those organisations and the funding of them are entirely different, so it is not reasonable to compare the regulator of social workers in Scotland with UK regulators.
Indeed, the General Social Care Council in England had the same structure as the equivalent body in Scotland, and one of the reasons why it was moved into our organisation was that, if it was funded purely by the registrants, unlike in the Scottish system, the cost of the fees would have been in the region of £200 to £250. That is why the transfer was made to the HCPC. I think that it is reasonable for me to compare us against the other nine UK statutory regulators, some of whose fees are up to £890 per year in comparison with our current £90 fee.
You asked where the organisation should be based. I think that it should be based where it can undertake its function. That could be done anywhere in the UK. However, we are based in Kennington, not central London, and our premises are very modest compared with those of other regulators. As for the amount of money that we will spend on renting accommodation for our fitness-to-practise hearings, we think that it is entirely reasonable in terms of what we do. Many of our employees live in south London, and they are not particularly well paid. It is quite reasonable for us to be based where we are, in Kennington. It would certainly be cheaper to be there than, say, being up in Edinburgh.
Do you really feel comfortable about the fact that senior management—including you, Mr Seale—are receiving substantial increases in salaries at a time when those of your registrants have been frozen? Your own salary went up by 17 per cent, or £26,000, in the course of two years. That amount is about the average income of your registrants.
I know that it was not you but the remuneration committee that decided on that—you are not responsible for your own remuneration. The remuneration committee increased the chief executive’s salary and the salaries of five senior managers by one band—we do not know how much in that band was increased, but the level certainly went up by a £5,000 band—at a time when registrants are being asked to pay a big increase and their rate of pay has been frozen. Is the system reasonable, fair and just for an organisation such as yours?
As you said, questions about the rates of pay for organisations such as the HCPC should be addressed to the remuneration committee. It is difficult for me, as a chief executive, to speak on behalf of the remuneration committee. A number of years ago, during the financial crisis, I decided that it would be appropriate to forgo my salary increase. I think that that was appropriate.
I think that, as an organisation, we pay reasonable wages. I do not think that they are out of order in terms of running an organisation. As you pointed out, however, those questions should be addressed to the remuneration committee of the organisation, not to me as the chief executive.
We will not get into a debate over pay levels. There are lots of organisations that pay salaries of £175,000, which is well beyond what the Prime Minister or First Minister receives.
The consultation period was very brief, as opposed to being lengthy. Your decision then came out within six days of the consultation ending. Frankly, that does not strike me as a period of either consultation or reflection on those 2,500 responses; that was a pretty good response in a very short period. The decision was made after a very short reflection on the issue.
I appreciate that you want the statutory instrument to be passed and that you want to make the increases from August this year. However, it does not sound to me like effective planning, if you have known about your IT systems and you have seen the increases in the number and complexity of fitness-to-practise cases, which did not happen overnight. I still do not understand why the process was—in my view—extremely rushed.
We were very disappointed by the incredibly low numbers and the low percentage of people who responded to the consultation. We have more than 330,000 registrants, and hundreds of organisations take a great deal of interest in how we operate as a regulator. The very small number of responses was very disappointing, particularly as we were asking questions, for example, on whether the registrants and professionals whom we regulate will pay on a six-monthly basis. We want to move to a system in which they pay on a monthly basis, thereby spreading the cost.
On how we analyse a consultation, we do not wait until the end, take all the results and start going through them. We have a well-tuned and good system: we start to analyse the first response when it comes in, which could literally be the day after the consultation starts, and we update the analysis and data as information comes in. Therefore, by the time we reach the end of the period for responses, we are in a position rapidly to come to conclusions as a result of the consultation. That is a good and efficient way to run the analysis, so we have no issue with being able to turn the result around relatively quickly.
The timing of the consultation was driven partly by the three issues that I mentioned. I will have to sign a cheque on 1 August—the first day that the PSA will be funded by the regulators. It will not be spread over two years so, in essence, that cash has to be given to the PSA on day 1. The HCPC has relatively low reserves and, compared with the other eight UK regulators, they are very small. Therefore, the need to get that cash to the PSA is pressing. We expect to make an operating loss of £1 million to £1.5 million in the current financial year because of the PSA levy and because we charge our registrants over a two-year period.
The consultation was not rushed. The analysis was good and, as I said, the small numbers of responses to it were disappointing.
The response was required in a brief time—six weeks, not six months—and your previous consultation had only about 600 responses. I accept that the figures were low, but the consultation was run over a time when there were three public holidays. There was also an election on and many of your registrants might have been actively involved in campaigning.
On the immediate payment of the cheque, I do not deny that you have to get the money in eventually, but you had a reserve of £3 million and the cheque to the PSA is, I presume, about £1 million, so paying it now to get it back later while allowing adequate time to consult would not have seemed unreasonable.
I am afraid that I simply do not accept your point.
On a point of clarification, I do not understand the point that you make about six months. The consultations that we normally run take 12 weeks. We follow Government guidelines on the length of consultations.
I am aware that, given that run, Mr Watson has not been able to get in, so I give him the opportunity now.
Thank you, convener. I will deal with that batch of issues.
I appreciate that this is not the raciest topic that I have ever come to the committee to talk about but, nonetheless, it is important because it deals with an increase in fees over which our members have no control and, therefore, on which they look to the committee for the appropriate level of scrutiny. As was pointed out, there was a 5 per cent increase, which was significantly above inflation. We were led to believe that that would be it for a couple of years and then we were hit with a 12.5 per cent increase.
As was also pointed out, we felt that the consultation was inadequate. It was open for six weeks instead of 12 weeks during an election purdah. A survey that we did of our members showed a suspicion that the consultation was done when it would be under the radar of at least UK parliamentary scrutiny. The seven days that were taken to consider the responses confirmed people’s views. That might be unfortunate but, nonetheless, that is the way that it looks to our members according to the survey.
We understand and have some sympathy with the point about the PSA levy that comes from the UK Government cut, but that accounts for only £3 of a £10 increase. The other costs are not entirely clear to us. There are headings—such as IT systems and accommodation—but there is no detail. Therefore, to the members whom we surveyed, it looked as though the PSA levy was being used as an opportunity to increase costs. According to its 2014 accounts, the HCPC made an operating surplus of £1.3 million and its reserves increased to £3 million.
Moreover, according to our survey, registrants do not believe that all the costs and working practices of this regulator have been fully examined. They are concerned that there might be unnecessary hearing costs, which is a very expensive part of what any regulator does. Indeed, 22 per cent of final hearings have been regarded as not well founded, and there is a question whether better filtering and other deterrents and education measures might reduce those costs.
10:45There is also a question whether, before whacking an increase in costs on our members, someone could have examined regulatory practice in more detail and taken more of a look at whether some regulators could have been pulled together or whether there could have been some streamlining of costs. Of course, this is an absolute monopoly; as our members have made clear in their responses, they have no option but to pay. Given that UK and Scottish Government pay policy is for pay rises of 1 per cent at best, these increases are way above any pay rises that members might get, and there has really been no consideration of, say, part-time rates—after all, many of the groups involved are part timers—or even a sliding scale based on the ability to pay.
I see the comparison with other groups, but I think that our members in this group are very often not the highest paid, and comparisons with doctors and dentists are not regarded as being particularly fair to operating department practitioners or paramedics. They are not on doctors’ or dentists’ wages, and such comparisons are regarded—to put it mildly—as unfortunate.
First, I refer members to my entry in the register of members’ interests as a member of Unison.
I want to ask about cost savings and, indeed, reviews of such savings. Dave Watson mentioned a number of things such as IT systems and, indeed, unwarranted investigations, which are really expensive. What work have you carried out on such matters to ensure that you are using members’ money appropriately?
I do not agree with the statement that there are unwarranted investigations. We have very clear processes and standards for investigating complaints against registrants, and round about 50 per cent of those cases have to go to tribunal. Tribunals are very expensive, but we have to test the evidence. Often professionals will not engage with us until the tribunal, at which point they explain very carefully what has gone wrong.
I think that we have to do two things. First of all, we have to keep in mind public protection, which is our single objective, but secondly, we have to look after the human rights of registrants in the processes that we run. We are scrutinised by the courts—as you will see, only a very small number of cases are referred there—and by the PSA, which looks at every single fitness-to-practise decision that we make. Moreover, there is an annual report, in which we are measured against our standards; we are audited by the National Audit Office; we have internal auditors; and we have ISO standards to meet. I personally think that it is absolutely important for our organisation to be scrutinised and checked, and I think that that sort of thing is done thoroughly.
With regard to savings, I have to say that I do not really understand the issue. When you run an organisation, you do not have a spare collection of things here or there so that when someone starts asking questions, you can quickly say, “We can save money there.” We run an efficient and effective organisation on a daily basis; we do not have a hidden supply of things that we can cut back on. As a result, I do not think that there is anything on which we could make any dramatic savings.
You say that 50 per cent of investigations go to tribunal, but the fact is that 22 per cent of those cases are not well founded, which means that 60 per cent of all the cases that you investigate and spend members’ money on go nowhere at all. Surely you could do something—say, work with people at a much earlier stage—to stop such cases becoming formal complaints. Would that not save you a huge amount of money?
I agree. For a regulator, it is incredibly important that inappropriate complaints are not raised, and we are taking a range of actions to address that matter. For example, we are carrying out research to discover not only why people make complaints but why registrants get things wrong. For example, we are looking for situations where we can go back to the universities and change the education of those professionals to ensure that they realise where things can go wrong.
We are also working with the professional bodies and the information that they supply to their members. Again, most of the complaints and disciplinary processes that we end up dealing with are not about professional competence but about issues such as conduct, behaviour and attitude. As a regulator, we want to minimise the number of complaints that come to us about situations where it would be inappropriate for us to take action. There is a huge amount of work that we can do in attempting to resolve such issues. I absolutely agree with your point.
There has clearly been an increase in the number of referrals and, in fairness to the HCPC, it is not unique. It is not that bad practice is growing in these or other professions, but a culture of routine referrals is developing in some areas. It could be argued that it is a defensive practice by employers.
The regulators need to filter complaints and deter them a bit more: they need to pick out what really matters. I accept that that is not always possible, particularly when it is a question of an individual’s capability or practice. In my department, I see a lot of the cases that go to our professional unit in London, and there is a wide variety: some should be there, whereas I wonder why on earth others are being called to a full hearing.
On costs, I put the figures on surpluses and I am sure that Marc Seale has said that the position might change in the coming years. Not many Scottish public bodies are increasing their reserves or making any surpluses at the moment. We should just ask for the standards that would apply in Scotland to apply to UK bodies when our members are required to register.
We have the lowest level of reserves of any of the regulators, in relation to not only the amount of the reserves but how long they would last. It is entirely prudent to have roughly about three months of reserves, which is what we have.
We need to make surpluses because we make capital investments. If we make no surplus or profit, we will not have the cash resources to invest in the organisation. The situation is slightly different from that of Government funding, which is done on a monthly basis.
On fitness to practise, my final point would be to emphasise that, as a regulator, we have the smallest percentage of complaints against our registrants. That is a reflection of the high level of professionalism in the groups that we regulate.
Three committee members wish to ask questions. We will get the minister back in at 11 o’clock, and we still have the debate to come.
I will split this into two issues.
First, you clearly have an obligation to the PSA; then there is other fundraising, for want of a better word. Is there any possibility that you could split that and go ahead with your obligation to pay what is due to the PSA? Are there any other means by which you could fund some of your other desires? Could you get Government funding, for example?
Secondly, if your obligation could be split, would there be merit in going out to further consultation, given that you got a small response the last time? I suspect that you might get a bigger response from your registrants because of what we have heard recently.
It is also my understanding that Westminster has not discussed the issue. What would be the effect if we were to annul the instrument today, with the matter then going to Westminster? What would the process be after that? How would things be affected? I know that it is complicated, but it would be good if you could deal with that issue.
I will try to answer some of those questions. If I miss any, please come back to me.
I suspect that I am not the best person to advise you on the process. As I understand it, if the committee says no to the instrument, it has to go to the full Parliament for debate.
I believe that this is new territory, and that the Scottish Parliament has not voted against a UK statutory instrument before. In Westminster, the process is called praying. Statutory instruments are prayed against every now and then, and I believe that the process is similar to that in the Scottish Parliament, in that the instrument has to go to a committee, the committee considers it and there is a vote. I do not know what happens beyond that.
In terms of funding, we do not normally make comparisons with other professional bodies such as the General Medical Council. However, we compare ourselves very closely with the Nursing and Midwifery Council. I am sure that others are more familiar with rates of pay, but we believe that the spread for nurses and midwives is similar. The NMC’s fee is currently £120, which is 30 per cent higher than ours. In addition, because the NMC got itself into some financial difficulties, the Department of Health has given it grants of about £22 million over the past few years to keep it going. The NMC is a good organisation for us to compare ourselves with.
In practice, the DOH has made grants to other regulators in times of difficulty, so that is a possibility. In terms of our legislation, although the provision has never been used, the Scottish Parliament could give us a grant if it saw fit to do so.
The position is that we must continue to invest in fitness to practise, and we must continue to deliver our statutory duties. We argue that a fee of £90, although we would like to have kept it lower, is what we need to continue to be an efficient and effective regulator.
Did I answer all the questions? Did I miss anything?
You more or less answered them. What would be the impact of delaying for further consultation?
Currently, even with the increase, we are heading towards a £1 million-plus loss. If the proposals are turned down by the parliamentary process, the first thing we would do is go back to the Department of Health and ask for guidance on how we should proceed.
As you said, the instrument has not been debated in Westminster, and I am not sure what the situation would be if the Scottish Parliament said no and Westminster said yes. We would certainly discuss our options with the Department of Health. In the medium term, that might mean another consultation.
I will not attempt to describe the procedures at Westminster, which are beyond even my legal brain, but I can say that we encouraged an early day motion to be tabled. I am pleased that it has attracted cross-party support from MPs from the Conservative Party, the Scottish National Party and the Labour Party, and, I think, the Liberal Democrats as well. They recognise that they have a role in scrutinising these instruments, because we do not have control over them and are very reliant on parliamentarians for that scrutiny.
I have some sympathy in relation to the PSA. The registrants in our survey were still asking what the function of that overview body is, as it seems to add a whole pile of costs to the exercise but does not do very much—I do not expect Marc Seale to comment on that concern.
There are certainly extra costs, and there is an issue about a wider review of regulation and some of the practices. Do we really need seven or eight different IT systems and everything that goes with them? Is this not an issue where more streamlining might save everyone a few pounds, which they could well do with at the moment?
We will move to the next question.
I will try to be brief because I know that the minister is to come back to the committee shortly.
I commend Richard Simpson for seeking to annul the instrument. I will not support him in that move, but he is shining a light on something that needs greater scrutiny.
I want Mr Seale to put one or two things on the record. In general, the HCPC’s efficiency needs to be scrutinised more by all Parliaments across the British Isles. Would he be content with that?
It is not for me to talk about our committee’s workplan, but, rather than going through a “Play it again, Sam” process next year, should the Parliament’s committees have an on-going role in scrutinising how effective and efficient the HCPC is as a body?
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Yes, we should be scrutinised by as many organisations as possible. We have pretty draconian powers—we can remove a job from a professional. As has been pointed out, we are effectively a tax on people, and some of those whom we regulate earn relatively small amounts of money. It would be good if, rather like the Westminster Government does, the committee were to invite us to answer questions or produce a report. That would be absolutely straightforward and a good idea. We are an important organisation, and it would be entirely reasonable to do that.
Is the poor consultation response on fee increases partly the HCPC’s responsibility? Should it engage more with the members of the professions to encourage them to respond? Is that a reasonable thing to say?
The number of people who respond to our consultations is always disappointing. However, we have always thought it important to meet the people whom we regulate. For the past 15 years, we have been going to various places throughout the UK—we go out up to eight times a year—to meet registrants. We have two sessions—one after lunch and one in the evening—at which we sit down and talk to people. A few weeks ago, we were in Middlesbrough, and in October we will be up in the Highlands for a couple of meetings.
Of great interest to the registrants are not issues such as fees, but issues such as continuing competence or fitness to practise. They are interested in their sometimes difficult working environments, where the demand on their time is a continuous pressure. Those are the issues that they talk to us about.
I will not support the motion to annul the statutory instrument. That has nothing to do with the HCPC’s performance; it is more to do with ensuring that the correct investment is made to improve the fitness-to-practise hearings and IT systems.
I note that the increase of £10 a year is around 3p a day. I do not make light of that small amount. The issue is more about a pattern—a trend—of increases. What assurances can you give the committee that what is required is a realignment and that we are not seeing an on-going trend of further, chunkier increases? Once people get a taste for double-digit increases, they might stick to them.
I have a couple of points to make in response. Again, please come back to me if I have not answered correctly.
First, if you are going to invite organisations such as the HCPC to the committee, you might also want to consider inviting the PSA, which is the oversight organisation, so that it can give its view on how the regulators are doing. It produces an annual report; it also issues reports on our fitness-to-practise process. It would be a good organisation to give you an oversight of all nine organisations with UK responsibilities.
I am absolutely committed to ensuring that we remain the lowest-cost regulator. We will do everything that we possibly can to ensure that we do not have any more significant increases, and we will try to keep our fees as low as possible.
I do not want to avoid the question, but it is quite difficult to give an absolute commitment and say that we will not put up fees for two years, because I do not know what is coming down the road. However, we will absolutely make our best endeavours to ensure that we do not put up our fees for the next couple of years. Is that a reasonable enough commitment, or do I sound as if I am hedging my bets?
That commitment will get you far enough this year. However, we will have a very different conversation if I am on the committee next year and some of the semi-reassurances—they are not full reassurances—are not met.
I will do my utmost to ensure that you do not have to invite me back next year.
Oh no—I think that you will be invited back.
We would welcome—I have indicated why—a more in-depth look at regulation and regulatory costs. I hope that it is clear from our submission and our members’ survey that members are, at best, confused about the need for the increases.
When we had the big 5 per cent increase, we were told that there was no plan to review the situation. I accept that things change. The point is that the thing that changed was the £3 out of the £10 increase, which is 30 per cent.
Presumably, things such as IT systems and accommodation were not dreamed up overnight so, frankly, the subsequent increase to 12.5 per cent does not match up with this having been dropped on us in the past five minutes. In the survey of our members that we had time to pull together, they told us that they felt that there was an element of opportunism here, with people saying, “Well, we’re doing the increase. Let’s get all this stuff under the one heading.” That is why we feel that the increases are unreasonable at this time.
We are now running behind, but Dennis Robertson has a question.
I will be brief. I note that the Health and Care Professions Council covers 16 professions and has 330,000 members. You give new graduates a 50 per cent reduction for two years, and you say that they can spread the cost of the fees by paying by direct debit every six months. Why can they not spread the cost through a monthly direct debit? That might make it easier for some.
Moreover, why is there a single flat fee? I suspect that the salaries in the 16 different professions will vary a lot, but even though some will be paid less than others, you still have a flat fee. Would you consider looking at differentials in the fees depending on salaries as well as offering the option of monthly direct debit?
When we consulted on moving to monthly direct debit, the proposal was well received, and we are now starting on a major IT project with the intention of bringing in monthly payments to allow individuals to spread the cost.
As for having differential fees for different professions, we have argued from day 1 that we should have similar processes and similar ways of regulating individuals, whether they are clinical scientists or arts therapists. The cost of the professions changes from year to year—for example, a particular profession might have a large number of complaints one year but not the next—and we think it fairer to have a single cost for all the registrants across all the different professions.
There are examples of regulators across the world that have a different attitude. For example, the Australian regulator is a multiprofession regulator with regard to the registration process; it has different fees for different professions, but what happens is that the very small professions end up with a registration fee that is significantly larger than that for the big professions.
We could try to do something related to the registrant’s salary, but I suspect that that would be a huge challenge. What would happen if people changed to part-time working or took time off for long holidays? It would become incredibly complicated. I think that our system and our approach are pretty fair.
I might be able to help with that point. The trade unions manage to do what has been suggested with our subscriptions; we do it through the salary approach, and I do not think that we are unique in that. The ability to pay is an important principle.
Okay. Dr Simpson, you have had five or six questions. Do you need to ask another?
I just wanted to ask why no equality impact assessment was done.
I am sorry—in relation to what?
Usually, when someone proposes a Scottish statutory instrument, they carry out an equality impact assessment. We are used to that in this Parliament. In this case, none has been done. A lot of your registrants are women, a lot of whom are part time or are on career breaks. I would have thought that an equality impact assessment would be critical as a matter of fairness, even if in this case it is not a requirement of the Government.
About 60 per cent of our registrants are female, so we are talking about a significant majority. We would expect the Department of Health to review the legislation, not us.
Okay. That is fine.
I thank the witnesses for attending this morning and answering our questions. The minister will now rejoin us with his team, but for once we will not pause to allow everyone to get set up. I want to move straight on as we are running a wee bit behind.
I welcome the minister Jamie Hepburn back to the meeting and extend a welcome to the accompanying Scottish Government officials: Fiona McQueen, chief nursing officer, and Ailsa Garland, principal legal officer.
I believe that the minister wishes to make some opening remarks. [Interruption.]
I am sorry, convener—I have just remembered that I need to turn off my BlackBerry.
That would be advisable.
I do not have much to say in advance, convener. I am happy to be here, and I think that it would be better just to move to questions.
I appreciate that, minister. Let us proceed.
We heard in the previous evidence session that the Scottish system for registering social workers is not the same as that in England and that the regulators’ powers, requirements and degree of independence are not the same. Even so, there is still quite a bit of difference in fees, with the system in Scotland costing £30 for social workers and that in England costing £90.
Does the Government subsidise the Scottish system? Is it run at a loss? After all, the costs for, say, child support workers are, at £10 or £15, considerably less; they are really quite low. Can you start by clarifying for the committee the differences in the registration processes for social workers in Scotland and those in England?
My understanding is that we do not subsidise the registration scheme in Scotland.
Is there a difference in function? When this morning we were trying to determine how efficient the HCPC was, we had various answers. In Scotland, we are running our organisation at a third—or in some cases even a fifth—of the cost to registrants. Indeed, differential fees are applied according to individuals’ income, which means that child support workers are, I think, now paying only £15. Does the HCPC provide a system of public protection to the country that our process in Scotland does not provide, or vice versa?
I cannot talk about the efficacy of the provisions for social workers in England per se, because that is obviously a matter outwith our control, but I am glad to hear your perspective on the system that we have for social workers in Scotland.
As for the fees that are set by the HCPC, that is ultimately a matter for it as a body. It determines the fees that it sets.
That is not my question. My question is whether, in the Scottish system of registration for social workers, the registration body does something radically different to what the HCPC does. Does our social worker registration process in Scotland protect the public in the same way that the HCPC process does in England? Do they carry out the same functions? I am not criticising the Scottish Government—in fact, I am praising it. The Government in Scotland is through its agency running a registration system that charges a third of the price that similar workers in England pay. The two categories of Scottish worker who would be charged £90 in England would, if they registered under the Scottish registration process, which is a multi-agency system, pay considerably less.
I am simply trying to understand that difference in cost. Why do we run such an efficient organisation? Are we actually protecting the public through our registration process?
Yes, I believe that we are. The bottom line is that the public should not be concerned about whether they are being protected by our system of registering social workers in Scotland. Incidentally, Dr Simpson, I should say that I am not used to getting your praise, but I take it gladly.
At this point, Fiona McQueen will say a few words about the specifics of your question.
The regulation of social workers in Scotland is relatively new, while the allied health professions, as they are known, that the HCPC regulates have been regulated for decades. Regulation of the social work workforce, which goes wider than registrants—support workers, too, are regulated for public protection—was a more recent creation in Scotland and, in relative terms, is newer. The Scottish Social Services Council has been looking at fees and the costing of fees, but it clearly believes that the current fees are sufficient for regulation in Scotland.
Does the SSSC perform pretty much the same functions as the HCPC?
11:15
The Social Work (Scotland) Act 1968 and the SSSC place requirements on employers with regard to professional registration and the professional conduct of social workers, and there is a requirement on employers to oversee the good character of social workers when they re-register with the SSSC. The HCPC regulates across the UK and regulates many other professions apart from social workers. It therefore does a broader job than the SSSC.
I think that that is clear. It sounds as though the bodies perform almost the same functions in respect of these two groups. I know that we are not responsible for social workers in England, but some English social workers might like to register with our body at considerably less cost.
As I understand it, this decision was approved by the Privy Council. Given that we have representation on that, why did we not insist on an equality impact assessment? Many of the workers who register with the HCPC are women, many of whom will take career breaks. However, re-registration after a career break is expensive, and it is a significant barrier to people whom we need to come back to the profession returning to it. Although the fee for general registration is increasing from £80 to £90, the career-break people face a rise of £25 to £225. No equality impact assessment was undertaken, and I wonder what representations the Scottish Government made when this matter was considered by the Privy Council.
I am not aware of any representations that might have been made to the Privy Council, but the Department of Health’s explanatory memorandum, which can be found in the papers for today’s meeting, explains that the changes were considered to be
“outside the scope of better regulation principles”,
which meant that an impact assessment was not carried out in the same way that it might have been for a statutory instrument that had been prepared by the Department of Health.
I think that I understand that, but it does not alter the fact that there is a differentiation, particularly for career breaks. Because it is mostly women who take career breaks, an equality issue arises when those fees are raised, and I really do not understand why an impact study was not carried out.
I have two other brief questions. Has the Government considered transferring the remaining designated practitioners who are covered by this body to a Scottish body, so that all practitioners in this group in Scotland are registered with the apparently far more efficient Scottish body? My other question, which is subsidiary to that, is whether the Scottish Government has subsidised or has ever considered subsidising the PSA. After all, the UK Government’s decision not to subsidise the PSA any more is part of the reason for the increase in costs.
On Dr Simpson’s point about career breaks, I note that we are already helping nurses to return to practice, and we could do the same for HCPC registrants. That is something that we are quite willing to look at, and Dr Simpson has my commitment in that respect.
On the question whether the Government has considered transferring the functions for those other than social workers to a Scottish specific body, we are not able to do that under the Scotland Act 1998, as it is a reserved matter. I would welcome Dr Simpson’s support for enhanced powers for this Parliament to allow it to consider such a move, but we cannot do what he has suggested at this time.
The Scottish Government is committed to working with the four Administrations across the UK to ensure that we have the appropriate regulatory framework. However, if we wanted to take a different approach—and I am not saying that we definitely would—my understanding is that that would require an amendment to the Scotland Act 1998.
What about my subsidy question?
Again, that was something that was agreed between the four Administrations. As you will appreciate, the public finances are constrained. We have supported the PSA in the past, but as an independent regulator, it needs to be independent of Government. However, that has helped to provoke the change in circumstances. We are where we are, but this is being led across the UK.
As members have no other questions, we now move to agenda item 5, which is the formal debate on the motion to annul. I invite Richard Simpson to move and speak to motion S4M-13509.
I thank the committee and the convener for the opportunity to debate this issue. In the 13 years that I have been in Parliament, this is the first time that I have considered moving a motion to annul a statutory instrument, but I feel that, at a time of austerity and when we have zero inflation, two increases in these fees in the space of two years is not desirable. The first increase was 5 per cent, which was a significant inflation-busting increase—although the sums are small, the principle nevertheless remains—and a second increase of 12.5 per cent, only part of which was forced by Government action at Westminster, seems to me to be completely unacceptable.
I have already gone into the issues clearly and I do not want to repeat them all, but I have concerns about an organisation that pays its chief executive an additional £26,000, which is the average salary of the registrants that the organisation looks after and is an increase in two years of 17 per cent. There are far too many huge increases like that at a time when our workers in the NHS and the care professions have had their pay frozen or had an increase of only 1 per cent.
Frankly, that 17 per cent increase is something that sticks in my craw; it and the fact that five senior managers are receiving increases that might be between £1,000 and £5,000 a year show a general disregard for the current austerity situation. An organisation that has a reserve of £3 million did not need to rush this matter; it could have paid the £1 million up front and then recouped the money later. The organisation made a surplus last year, so if the additional charge had not been made, the loss would have been about £300,000 this year, as we heard from Marc Seale—and it has reserves of £3 million. The additional charge of £1 million could therefore have been met up front.
I am utterly appalled at the fact that there is no equality impact assessment of what is proposed. We have a situation now in which women and men will take career breaks when they have a family—it will particularly be women—and, although it is entirely justifiable for individuals to make that choice, they will be faced with a charge of £200 to come back into a profession where they may well work part time and be paid a very low wage.
I therefore think that the proposed increase is unnecessary and unjustified. It should have been properly consulted on over a proper length of time and not just a six-week period that included three public holidays, which shortened the consultation time further, and was at a time when the Westminster Parliament was in purdah. I very much welcome the fact that some SNP MPs have now signed the early day motion in Westminster against the increase, and I welcome their support.
I move,
That the Health and Sport Committee recommends that the Health and Care Professions Council (Registration and Fees) (Amendment) (No. 2) Rules Order of Council 2015 (SI 2015/1337) be annulled.
Thank you. Which members wish to participate in the debate? I see that Mike MacKenzie and Bob Doris do, and so does Nanette Milne.
Thank you, convener. I will try to be brief, but you will probably know that my brevity agenda is not proceeding as quickly as I would like, so if you feel that I am speaking for too long you can perhaps give me a signal. [Interruption.] I thank Richard Simpson for that signal, but I was referring to the convener.
I had to do a bit of a double take when I was looking at my committee papers this week. I initially thought that this was a £10 a week rise, but I did a bit of a double take and saw that it was a £10 a year rise. I do not wish to make light of that, because in these difficult times we must all work to keep costs down, especially unanticipated costs, on behalf of everybody across the country. As Mr Doris pointed out, however, the increase equates to a bit less than 3p a day or 20p a week, and that is a cogent point in this debate.
Let me put the issue in perspective. I represent the Highlands and Islands, as does Rhoda Grant, and many of our constituents are forced to use ferries to get to work. On Orkney, Shetland, and Argyll and Bute, local authorities run internal ferries and people often pay £10 a day for a short journey of under 10 minutes. Some of those people think that that is a tax on employment. I know that it has nothing to do with this committee, but it is nevertheless an important point that often is not recognised. Some of those people are on the minimum wage, and we are also in an era of welfare cuts that affect individuals by amounts that make this measure pale into insignificance. I do have sympathy for those affected, but it is tempered by that wider context, and the committee would do well to dwell on that when it considers Dr Simpson’s motion.
Some interesting and substantive points have been made during our discussions, and the PSA levy undoubtedly requires further scrutiny. I am sure that Mr Seale cannot have helped but be impressed by how finely the mill of the Scottish Parliament grinds, and I am sure he did not anticipate the detail and level of questioning. In future it might be worth while for the committee to direct questions to the PSA about its levy, on the principle that it behoves all public bodies to operate in an efficient manner that delivers best value.
Dr Simpson raised a point about the chief executive’s salary, although that is only tangentially pertinent to this issue. I do not think that a £26,000 rise in these difficult times for any individual, especially one who is already highly paid, is acceptable. Dr Simpson raised a further important point about the equality impact assessment. I am glad that he has lodged his motion as that has allowed us to discuss those important points, but given the overall context I am afraid that I cannot support it this morning.
I commend Mr MacKenzie on his lack of brevity because I no longer have to make a number of points that I was going to raise during my submission. I am not making light of the burden on employees, but I want to put some perspective around the figure of 3p a day, because that must factor in to whether we annul this statutory instrument. Given that the fitness-to-practise methods and IT systems will be enhanced, I am not minded to annul it today.
I suggest to Mr Seale that the fact that we do not necessarily get the answers we want is not a reason for the committee not to invite him back—indeed, it is a reason to invite him back more frequently. Dr Simpson has done Parliament a service by shining a light on whether or not the HCPC is efficient. I have no idea whether it is efficient, and we must scrutinise it in future. I am not sure what role the committee can appropriately play regarding pay increases at the top of that organisation, but perhaps we will shine a light on that in future in a way that might not have happened if Dr Simpson had not moved to annul the SI today.
The overarching point is that this is not about a 3p a day increase; it is about the trend and trajectory of potential increases in future. As I said earlier when questioning the witnesses, organisations can get a taste for such increases, and I did not quite get the assurances I was seeking.
Although I commend Dr Simpson for bringing the matter to our attention today and for making a lot of salient points, I will not be supporting the motion to annul, although I suspect that the committee will be considering the matter again not just this time next year but well in advance of that, to ensure that the HCPC actually does some of the things that we would expect it to do.
11:30
I find myself torn over the issue. I can see all sides of the argument. I accept that there is an obligation to the PSA, which must be dealt with. I also accept that, in relative terms, the HCPC fee is lower than those of some other regulatory bodies. I respect the HCPC’s commitment, as was stated today, that it will try to keep the fees as low as possible, without further projected increases in the foreseeable future.
I would have liked to hear about alternative means of raising money to fund the HCPC’s necessary IT systems and to address its accommodation problems. I welcome the fact that the organisation has committed to monthly payments of fees. As Mike MacKenzie has said, the amounts are relatively small in cash terms, although the rise is a big one in percentage terms. I welcome the opportunity to make monthly payments. To my mind, that will need efficient IT systems. That takes me round in a full circle, except to say that the fee should perhaps go up in order to accommodate the investment in infrastructure that is needed.
There is a need to consider efficiencies. I will not be a member of the committee next time round, as I am retiring from Parliament, but I would like the issue to be addressed in future sessions. The HCPC, and indeed other regulatory bodies, should be scrutinised carefully to ensure that they are indeed efficient and good value.
I am probably coming down on the side of not agreeing to annulment of the instrument. I note that Westminster has not yet discussed the order, and I will be interested to hear how its discussion goes. I presume that there will be such a discussion in time to come.
I am sorry to be so torn, but that is the way that I have tried to reason things out.
I speak in support of Richard Simpson’s motion. I do not take an awful lot of comfort from the reassurances that were given about there being no further large increases, as we were given such an assurance previously and this increase is even larger than the previous one.
Mike MacKenzie spoke about the costs to people working in rural areas. Mileage and petrol costs are indeed a huge burden on rural workers, and the increased fee just adds to that burden. The increase might appear to be small, but given the costs that other people are bearing—with pay freezes, increased travel and other costs—it just adds to the burden. I will therefore support Richard Simpson’s motion.
I agree with the view that it has been useful to have this debate; it is very sensible for the committee to have done so. This is, of course, a matter for the committee, and far be it from me, as a member of the Government, to say what the committee should do, but I think it is a very sensible suggestion that the committee continues to examine these matters.
The change that we are discussing has been driven by factors beyond the levy to the PSA but, taking that as a starting point, it should be pointed out that this Parliament has already agreed the changes for funding the PSA. I understand that the instrument that set out those changes came before the committee on 23 February.
This discussion goes beyond that particular issue. The HCPC has a need to upgrade its systems and to ensure that they are up to speed so that it can properly regulate the profession for which it has responsibility. I am not unsympathetic to the concerns that have been expressed. How could anyone be? No one wants to have to pay more.
It is important to place the rise in fees in some context, as Mr Doris and Mr MacKenzie have sought to do. I know that there was an exchange about this earlier. In comparison with the other professional regulatory bodies, the HCPC, even with the fee increase, comes in significantly at the bottom of the league. It has by far and away the lowest of any fee among the UK professional regulatory bodies.
The increase has been described as 12.5 per cent; I cannot say that that is incorrect, but I also think it important to put the increase in its proper context. In that light, it turns out to be £10 a year—and less when we take into account the fact that some of it can be recouped through tax payments.
There has also been some discussion about the fee in the other context of pay policy. It is important to recognise that not everyone who is regulated by this body is covered by public sector pay policy; some work in the private sector. However, if you look at Scottish public sector pay policy, you will see that the NHS staff who come under agenda for change and are covered by this body—and to whom, therefore, the increase will apply—are expected to be in at least band 4 or, as is perhaps more likely, band 5. Last year and this year, we have implemented the NHS pay review body recommendations for an uplift to all scale points while maintaining progression, and this year band 4 staff who have still to reach the top of their scale will have received an increase of about 4 per cent ahead of the 1 per cent that has been referred to. That will more than make up for the amount by which the HCPC is increasing the levy.
We have contacted the HCPC as a body, and it has set out its commitment to us as an Administration that, as has been mentioned, it wants to move to a system of monthly payments, which I think will make things easier for those who have to pay the levy. I also point out the commitment not to increase the fees again in the foreseeable future. I hear what has been said about that, but we need to take that commitment at face value; indeed, I do not see how we can operate fairly on any other basis.
The annulment—if the committee were to agree to it, which I sincerely hope will not be the case—would impact on the HCPC’s ability to regulate the professions for which it has responsibility. I also presume that it would not be able to upgrade its systems in the way that it wants to, and my understanding is that, without this increase, its funds could quickly end up in deficit. That would impact on public safety, which, after all, is ultimately what regulation is all about. On that basis, I strongly urge the committee not to annul the order.
I entirely accept that the amounts involved are small, but this is a matter of principle. The staff involved have had a pay freeze, which I will admit that the Scottish Government, unlike the Westminster Government, has mitigated; they have had their pension contributions significantly increased; and they were told that the 5 per cent increase in fees, which was above inflation, would be the last increase for two years. Some of the individuals concerned have still not paid that fee increase—they have not got through the cycle—and now the HCPC is already back looking for a 12.5 per cent increase.
Given all that, I do not think that the sums involved matter here. That said, however, I note that career break charges have been increased by £25 to £225—which I think is a significant sum for those returning to work, given that many of them will be coming back part time—and that the grandparenting charge has also been significantly increased to £440. Those sorts of sums begin to matter, and mitigating the situation through monthly direct debit, although welcome, is insufficient.
We heard in the evidence-taking session—which I thought was very useful, and I thank colleagues for the questions that they asked—that there has been no attempt to link the fee to income. That is not appropriate, particularly when many of these workers are part-time. It appears that the Scottish body is much more efficient, which makes me wonder what sort of supervision the PSA is carrying out. It should be coming to our Scottish body and saying, “You clearly run a show that the public, the Government and the Parliament have confidence in and which is hugely more efficient than what is happening at a UK level. Why are the costs for the English body three times that proposed for the Scottish body?”
The final thing that made me move this motion was Marc Seale’s comment that the HCPC has no off-the-peg efficiency savings that it can make. Every single public body in Scotland has had to make efficiency savings. Those may have gone back to the body concerned and there may have been improvement, but saying that the organisation cannot make efficiency savings—that is how I interpreted what Marc Seale said—was a manifestation of an organisation that needs to be scrutinised much more closely.
I welcome the fact that others will scrutinise those bodies much more closely after I depart from the Parliament next year—I will not be standing again. However, I want to press the annulment because I want the Parliament to send out a message to the 329,000 registrants across the UK and to the UK Parliament that the matter should have been scrutinised far more closely.
The sums involved are not large for the PSA. They should have been paid by the Government until there was adequate consultation time on the issue. That has not been provided in this instance. More time should have been given and more costings should be provided. It should not simply be said that an IT system needs to be improved or that office costs will expand because more room is needed. That is not good enough. The costs were not adequately provided, and I am not prepared to subscribe to an organisation that does not lay out its costs very clearly and in great detail. Therefore, I press the motion.
The question is, that motion S4M-13509, be agreed to. Are we agreed?
Members: No.
There will be a division.
For
Grant, Rhoda (Highlands and Islands) (Lab)
McNeil, Duncan (Greenock and Inverclyde) (Lab)
Simpson, Dr Richard (Mid Scotland and Fife) (Lab)
Against
Doris, Bob (Glasgow) (SNP)
Keir, Colin (Edinburgh Western) (SNP)
Lyle, Richard (Central Scotland) (SNP)
MacKenzie, Mike (Highlands and Islands) (SNP)
Robertson, Dennis (Aberdeenshire West) (SNP)
Abstentions
Milne, Nanette (North East Scotland) (Con)
The result of the division is: For 3, Against 5, Abstentions 1.
Motion disagreed to.
That concludes parliamentary consideration of the instrument. I thank the minister and his officials for being with us.
We will pause for just a wee bit to get our witnesses in place and move quickly to agenda item 6.
11:42 Meeting suspended.Previous
Carers (Scotland) Bill: Stage 1