Successive governments have committed themselves to reducing the scope and cost of regulation and then done precisely the opposite. This is particularly true of the regulation of health care professions which, following various scandals, have been subjected to draconian changes to their regulatory structure.
This has resulted in increased costs which fall on the shoulders of professionals, and in the case of the GOC bodies corporate. It, therefore, came as no surprise that there was a substantial increase in GOC retention fees last year. Last week those of us who predicted this was the tip of the iceberg were proved correct. An increase of 48 per cent for optometrists and rather less for DOs has been met with a justifiable howl of protest.
There is a litany of excuses for the budgeted jump in expenditure from £4.02m to £5.70m. However, with a convenient change in presentation, moving staff salaries to cost centres, it is difficult to see exactly where the increases will be incurred. What is clear is that staff costs have leapt from £1.24m to £1.80m in three years. The cost of fitness to practise continues to escalate and this is before it is passed to the independent adjudication panel with, no doubt, a further escalation in costs. In the past, increases in retention fees were subject to approval by the Privy Council. The Council now has power to set fees apparently without further approval or oversight. One might well ask why this increase is necessary when in similar circumstances neither the General Medical Council nor the General Dental Council have increased their fees.
The decision to introduce a differential fee for OOs and DOs can only be seen as extraordinary. Apparently, this decision was based on 85 replies to a consultation, hardly a representative number of some 18,000 registrants. We are told that the costs of regulating DOs is less than that for OOs as they generate fewer fitness to practise cases and that they present less risk to the public. No mention is made of the risk that CLOs present, maybe there should be a further differential fee for them! In reality, OOs outnumber DOs by more than two to one and, therefore, optometry already contributes a third more than dispensing optics. The suggestion that there should be a lower fee because dispensing is partially deregulated and that DOs might fail to register is an old chestnut. Partial deregulation took place in 1985 and the threat of DOs not renewing their registration would mean they would be unable to practise as opticians or use that title. It is said that other regulatory bodies charge differential fees apart from the dentists who have a lower fee for support staff. It could well be said that in applying differential fees DOs will be seen as second class professionals.