Editorial - NMBI fee increase – simply inexplicable

The decision by the Nursing and Midwifery Board of Ireland (NMBI) to seek an increase in the annual retention fee, of 50% (80% over two years), is inexplicable and demonstrates a complete loss of contact with the two professions. Since this decision was made, the INMO, together with our colleague unions, has commenced a campaign of opposition to the increase. The steps in this campaign are covered on pages 6-7 in this journal.

It is necessary, when considering the need for this campaign of opposition, to reflect on the role of the NMBI. In particular how it can serve the public while failing completely to provide active, current and relevant advice and guidance to nurses and midwives in clinical practice. The silence of the NMBI in recent years as over 5,000 nursing/midwifery posts were lost, workloads became intolerable, staffing levels became unsafe, and the role of individual nurses and midwives to mentor/preceptor their young colleagues became impossible is damning of itself. Every regulatory body must be prepared to monitor and respond to changing clinical environments that could negatively impact on the ability to provide safe care.

Equally, the silence of the NMBI on the impact on placements for undergraduates, arising from the severe contraction in the qualified nursing/midwifery workforce, is impossible to fathom. How can you protect the public interest while expressing no view on the environment required to ensure world-class quality in all aspects of undergraduate programmes?

The NMBI has no difficulty whatsoever in incurring millions in costs presenting fitness to practise hearings against individual nurses/midwives. No-one understands how the NMBI can stand in judgement of poor practice, if it arises, but makes no comment about the resources and infrastructure that must be present to ensure best practice.

It is against this background that you have the anger, frustration and puzzlement that has emerged since the Board’s decision to seek an increase in the retention fee. The INMO, as well as our two colleague unions, can readily report that the strength and volume of the feedback from members on this issue is loud, continuous and focused. It is clearly saying that there is no justification for this increase, and that even the attempt to seek an increase of 80% in two years demonstrates a level of separation and detachment that leaves one to wonder whether it can ever be bridged.

The ongoing campaign includes a public protest on November 18 outside the NMBI HQ in Blackrock, scheduled to coincide with a board meeting. No-one, in the professions of nursing and midwifery, can take joy from the need to organise such a protest. However, and this is critical, no-one can express support and confidence in the NMBI based on its recent approach towards nurses and midwives. It is a fact that this latest increase, the third in as many years, could well be followed with further increases.

The solution must involve a reversal of the increase, a complete realignment of the role for the NMBI, which would give primacy to the public interest but do so through action that will see the Board being supportive of nurses/midwives in the clinical area. It must lead to open and transparent cost containment measures, particularly in relation to current levels of expenditure with regard to external consultants, public relations and legal costs, which it refuses to disclose.

We need a strong regulatory body. This is best achieved by having a Board that protects the public interest by ensuring nurses and midwives have a clinical environment where safe practice can exist and grow. To date, the NMBI has simply failed to meet its obligations and nurses/midwives are tired of supporting a regulator that has failed both patients and the professionals.

Liam Doran
General Secretary, INMO

Editorial - NMBI fee increase – simply inexplicable

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