9% increase in registration fees – a psychological straw for struggling providers
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A proposal by the Care Quality Commission to increase registration fees for adult social care providers by 9% has been criticised strongly by provider representative body Care England.
In its response to the CQC consultation on fee increases Care England said that, while it supported the regulator’s direction of travel, CQC had still to deliver changes for a sustainable amount of time and that registration fees should not be increased when the improvements promised by CQC were still to be delivered consistently.
Care England chief executive Professor Martin Green said the fee increases were being proposed when local authorities had cut their adult social care budgets by 26% since 2010, the equivalent of £3.53bn.
“This proposed 9% increase might, for some providers who are really struggling, be the straw that breaks the camel’s back,” said Prof. Green.
“Not of itself but it may well be a psychological final straw where people think ‘not only are we being forced to deliver higher and higher standards, but we are not taking any money out of this business and now we are being asked to pay even more for the people who oversee us rather than spending that money on providing a better service.”
Prof. Green said he knew of care businesses where people were struggling to the point where the owners were not taking their salaries. These tended to be smaller homes operating on very tight margins, and whose situation would worsen with continued downward pressure on fees and increasing costs, not the least of these being a likely increase in the minimum wage.
“In effect CQC is presenting people with a fait accompli,” said Prof. Green.
“They have taken no account of providers’ capacity to pay, and they haven’t made a clear enough case as to what the benefits of this increase will be, both to people who use services or to the sector. They have just said ‘we have a deficit position, we need to close that gap’. What would happen if care providers did the same thing to local authorities in the commissioning process? CQC appears to live in a universe that is not inhabited by the rest of us.”
Prof. Green said CQC should set its fees with equity across all the services it regulates and that he couldn’t see why care providers should be paying almost all their cost of registration while GPs are getting away with paying only about 75% of the full cost.
“Let’s not forget that GPs are exactly in the same space as care providers – they are independent contractors to the NHS,” said Prof. Green. “Why are they are getting a cushion when the rest of us are being compelled to pay for the vast majority of our registration costs? If CQC is going to aim for full cost recovery then that should apply to everybody.”