Seven-fold CQC fee hike risks devastating impact on GPs, BMA warns

CQC plans for an 'exorbitant' increase in fees that would cost GPs £40m a year threaten the future of small GP practices and risk damaging patient care, the BMA has warned.

BMA chairman Dr Mark Porter
BMA chairman Dr Mark Porter

The CQC announced last November that it would increase fees for GP practices seven-fold either over the next two or four years – amounting to thousands of pounds per year for the average practice. The watchdog has said this is necessary to recover its ‘full chargeable costs’ from providers in line with government policy.

But the charges – which would see a 5,001-patient GP practice’s fees leaping from £725 to £4,839 – threaten the survival of small practices, BMA leaders have said in response to an official consultation.

The BMA said the increase means GPs as a whole would contribute over £40m a year to maintain CQC fees, diverting funds away from patient care.

The watchdog currently relies on grant-in-aid from the DH for a significant proportion of its funding, only recovering 51% of its costs through GPs and other providers.

The consultation, opened alongside the fee rise announcement, ran until Friday 15 January, asking providers for feedback on whether the rise should take place over two or four years. CQC will publish the final decision in April this year.

Map: GP CQC ratings

The BMA warned the consultation was 'essentially meaningless'. It said the vast majority of responses came from GPs, and just 4% backed the two-year implementation plan, while 38% refused to back either the two or four-year schedules.

In the BMA response to the consultation, it wrote: ‘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 spend, while in reality mercilessly raiding a budget, purportedly ring-fenced 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.’

GPC chairman Dr Chaand Nagpaul said: 'These proposals are disproportionate, unacceptable and wholly illogical, especially at a time when the CQC has stated it intends to scale down its future GP inspection programme. This inexplicable seven-fold rise in fees will take vital resources away from frontline patient care, and will threaten the viability of many practices who are struggling to survive financially in the face of rising patient demand, increased practice expenses, staff shortages and more care moving out of hospitals.

NHS bureaucracy

'The BMA totally rejects these proposals, which need to be withdrawn. What we need is a fundamental overhaul of the CQC inspection regime that addresses the key problems with a failing, bloated bureaucratic system that is not delivering for patients.'

BMA chairman Dr Mark Porter 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.

‘Only last year the CQC had to abandon part of its programme which judged GP practices before inspectors even walked through the surgery’s doors.

‘Everyone in the medical profession wants an effective regulatory system that maintains patient safety, but this will not be achieved by these flawed proposals. The CQC need to put a halt to this process and put forward a genuine consultation that leads to a cost effective system that is value for money for the taxpayer.'

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