CQC acting like medieval 'robber baron' over fee hikes, warns former GPC negotiator

Derbyshire LMC has demanded that the BMA launches a formal dispute with the government over the CQC's 'unfair and unjustifiable' decision to sharply increase fees it charges to GPs for regulation for the second year in a row.

Former GPC negotiator Dr Peter Holden

An open letter to the BMA from Derbyshire LMC, penned by former long-standing GPC negotiator Dr Peter Holden, said there was an ‘extremely strong feeling that enough is enough’.

The letter comes after the CQC set out plans last month to raise the fees it will charge GP practices in 2017/18 by 76% compared with the current rate - a move that comes just a year after the watchdog tripled the amount it charges GPs. BMA leaders have called the increase 'outrageous'.

Dr Holden's letter says the CQC’s fee increases ‘have no possible justification’, comparing the regulator’s behaviour to that of ‘robber barons of the Middle Ages’.

It added that the proposed fee hikes are tantamount to ‘an abuse of a monopoly of power’, because practices cannot take steps to increase their prices to meet the increased costs like most traditional small businesses would.

CQC fees

The CQC maintains it was forced to increase the fees charged to GPs almost seven-fold after the government decided to withdraw grant-in-aid funding to supplement provider fees. NHS England has pledged to cover practices' increased costs but GP leaders say this risks diverting funding from frontline patient care, and argue that CQC plans for lighter touch regulation should reduce the amount of funding it needs.

The GPC recently labelled the CQC’s proposed 2017 fee increase as ‘scandalous’ and called on the watchdog to halt the plans.

But Derbyshire LMC’s letter warned that a 'mild-mannered hand-wringing response' was not acceptable, calling for the BMA to take firmer action against the fees.

‘The LMC believes that GPC/BMA should declare a formal dispute with the government over these particular matters concerning the CQC,’ it said.

‘We recognise that refusing to pay is tantamount to breaking the law. Our belief is that practices should pay the monies into an escrow account that Derbyshire LMC is asking the GPC/BMA to set up and co-ordinate.

‘The concept is that practices pay the CQC fees be held by the GPC/BMA on behalf of the profession and they will be released to the CQC upon satisfactory arrangements being concluded to deal with CQC, their fees and their unwarranted and unreasonable other demands.

'Derbyshire LMC is looking for an appropriate response from GPC/BMA and I can report that a mild-mannered hand-wringing response of the "it is too difficult" variety will not be acceptable.

‘It is now time to start showing some teeth to the government however delicate the current negotiating position may be.’

The letter comes as the result of a meeting last week held by Derbyshire LMC members. It urged the BMA to respond ahead of its next meeting, on 12 January 2017.

A BMA spokesman said: ‘GPC has repeatedly called for the ludicrous increases in CQC fees to be reversed and for a wholesale review of the entire inspection regime and the funding drain it inflicts on general practice.

‘Given the huge pressures on GP practices, it is perfectly understandable that GPs and LMCs like Derbyshire are furious at the costs they are incurring at a time when GP services are struggling to deliver services to patients.

‘Following pressure by GPC, the CQC fee rise this year was fully reimbursed through an increase to core practice funding.  We are now in active discussions to secure additional new funding to fully cover the projected rise next year.’

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