“Exorbitant” regulator fee rises will damage patient care, warns BMA

BMJ 2016; 352 doi: (Published 21 January 2016) Cite this as: BMJ 2016;352:i390
  1. Zosia Kmietowicz
  1. 1The BMJ

Doctors’ leaders have warned that “exorbitant” and “inexplicable” planned rises in the fees that GPs and hospitals have to pay to England’s healthcare regulator amount to a “raid” on overstretched NHS budgets. They say that the rises could undermine the care of patients and threaten the future of small general practices.

The Care Quality Commission has been consulting on its fee rises since November, for implementation in April 2016.1

It has proposed that charges for a general practice operating at one location that has between 5000 and 10 000 registered patients should rise from £725 (€1015; $1120) a year for 2015-16 to £4839 a year. The annual fee for practices with premises at five locations would rise from £2681 to £17 839.

In its response to the consultation, which closed on 15 January, the BMA said that, although NHS trusts with turnovers of between £125m and £225m would see a threefold rise, from £78 208 in 2015-16 to £215 835 in 2017-18, some GPs would see a sevenfold rise in two years.2

The BMA’s response to the consultation said, “By forcing NHS providers to pay fees direct to CQC—masquerading as full costs recovery—the Government will no doubt assert a decrease in DH [Department of Health] spend, while in reality mercilessly raiding a budget, purportedly ringfenced for frontline services.

“As the sole provider of system regulation and consequently with a monopoly and captive market, the CQC is an increasingly bloated bureaucracy with little focus on value for money or analysis of the real performance indicators linking cost to quality outcomes.”

Mark Porter, the BMA’s chair of council, said, “This is a cynical set of proposals that will force parts of the NHS to hand over large chunks of their budgets to the CQC without any evidence of a positive benefit to patients. This comes at a time when the NHS is under unprecedented pressure, trying to find the 2-3% efficiency savings demanded by the government while attempting to cope with increasing patient demand on inadequate funding and staffing levels.”

He said that the CQC had failed to explain why the “ridiculous rises” were needed. “These rises cannot be allowed to go ahead, as they amount to a raid on funding: in practice these proposals will cut budgets earmarked for patient care,” said Porter.

The CQC will make its recommendations to England’s health secretary, who is responsible for making the final decision about fees. It expects to publish the final fees scheme in March 2016, for implementation on 1 April.


Cite this as: BMJ 2016;352:i390


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