Professor Steven Field CBE
Chief Inspector of General Practice
Care Quality Commision
NEWCASTLE UPON TYNE
9th December 2015
An Open Letter to Professor Field CBE
Dear Professor Field,
I, along with many of my colleagues in Primary Care, am concerned regarding the proposed increase of fees paid to the Care Quality Commission by Primary Care providers. We are aware that the Treasury is demanding this increase in that they are removing the grant-in-aid to CQC and the current consultation is debating whether to reclaim those increased fees over the next two or four years. I felt I had no option but to write to you directly as I fear not only for my practice, but that of my colleagues across the country.
This proposal means that fees will rise by a whopping 567% and this will absolutely financially cripple many Primary Care Providers and will negatively impact upon service provision. Practices could find themselves in a position where they must close branch surgeries in order to move down a bracket in the fee structure, i.e. pay less fees for one site rather than two. Some surgeries may find the fee to be paid as ‘the straw that breaks the camel’s back’ and will, through no fault of their own, have no choice but to close their doors to their patients. Quality of care will be adversely affected, as practices will have no option but to cut services and personnel in order to meet the extortionate fee currently being suggested. Such an action would be damaging to the patient/doctor relationship and would discriminate against patients with disabilities/those unable to travel to other branch sites. This would surely conflict with the CQC commitment to ensure “that people receive safe, effective, compassionate and high quality care”. The money for CQC fees comes directly out of NHS funds – and if we all pay the increased fees in the next couple of years, it could represent some £40 million of NHS monies. This does not sit easy with us in Primary Care, and I’m sure, as a GP yourself, you must agree that something should be done.
I understand from a recent interview you gave that the Dept of Health has stated it will reimburse Primary Care providers but I have yet to see that statement released. If this is the case, we may feel a little easier, but clearly it would make more sense for the Dept of Health to reimburse the Treasury directly. This would undoubtedly reduce the administrative burden for everyone concerned.
I must make it clear that I am not against regulation or inspection. Having had an inspection, I have found the process useful. However, I cannot under any circumstances understand a process that removes some £40 million of NHS money directly away from patient care. We are at breaking point and cannot continue. To that end, we respectfully request a review of the Primary Care Registration Fees structure, as we do not feel that a rise in fees of 567% is justified in any way.
I would be grateful to hear your thoughts on this matter.
With best wishes,
Nicola Hayward MA
Photo: CQC Press Office