Treasury and Resources
Ministerial Decision Report
Fee increases to support establishment of a Care Commission
Piercing and Tattooing (Jersey) Law 2002
Nursing and Mental Nursing Homes (General Provisions) (Jersey) Order 1995
Residential Homes (General Provisions) (Jersey) Order 1995
Nursing Agencies (General Provisions) (Jersey) Order 1978
- Background
In July 2014 the States approved the Regulation of Care (Jersey) Law 2014 (P94/2014). This provides for the establishment of a Health and Social Care Commission to oversee the regulation of health and social care activities on the Island. In adopting the Law, the States agreed that additional costs associated with the new regulatory framework should be met through the fees paid by regulated services, and that those fees should be proportionate.
The new Law cannot be fully implemented until secondary legislation in the form of Regulations and Standards are in place. Those Regulations must be adopted by the States and the Standards must be developed and adopted by the Commission.
This means that:
- The Commission must be established in shadow form[1] in order for the new Law to be implemented and;
- in accordance with P94/2014 the fees paid by regulated services must be increased to cover the Commission’s costs.
The Regulation of Care (Jersey) Law 2014 sets out that the Commission must be established by the Chief Minister.
Anticipated costs for 2016
It is anticipated that in 2016, the costs associated with setting up and running the shadow Health and Social Care Commission will be £27,770. This includes: recruitment costs; travel and subsistence and the daily rate paid to the Commissioners (£570 per day for Chair of Commissioners; £370 per day for other Commissioners)[2]. These costs must be met through fees paid by regulated services, providing that these fees are proportionate (in accordance with the States decision in relation to P94/2014).
The 2016 fees, as set out below, are intended to raise an estimated £27,999 more income in 2016 than was raised via the fee income in 2015. The income will be raised by the Health and Social Services Minister who is responsible for the relevant laws.
2016 fee increases
Piercing and Tattooing (Jersey) Law 2002
The Piercing and Tattooing (Jersey) Law 2002 (the Law), sets out a requirement for both individuals and premises to be registered to undertake certain skin piercing and tattooing procedures.
Under Article 2 of the Law, registrations lapse each year on the 31st December and under Article 3 of the Law, the Health and Social Services Minister may prescribe, by Order, a registration fee to accompany an application to register or renew a registration.
To date no fee has been charged and the States of Jersey is currently bearing the cost of regulating this sector.
The Health and Social Services Minister has therefore determined that, subject to approval from the Minister for Treasury and Resources, the following fees should be charged for all registrations or renewal of registrations for a premise or a person administering piercing or tattooing treatments for 2016 and therefore (or until the point at which those fees are further amended by Order)
Table 1
| Fee to apply for registration or renewal of registration 2016. |
A Person registered under the Piercing and Tattooing (Jersey) Law 2002 | £55 |
A Premises registered under the Piercing and Tattooing (Jersey) Law 2002 | £100 |
Proportionality of fees: The 2016 fees represent an increase in costs for piecing and tattooing premises and practitioners as no fee is currently charged. It should be noted that:
- whilst 2016 fees help met the additional costs incurred by the Shadow Commission they do not cover the full cost of regulatory services provided to piercing and tattooing practitioners and premises, the rest of which are borne by the States of Jersey;
- the fees equate to £0.96 per week for practitioners and £1.92 per week for premises. This is comparable with the mid-range of fees charged by UK local authorities which varies from £42.50 to £286.
The Health and Social Services Minister will request from the Law Draftsman that a new Order prescribing the fees, as set out above in Table 1, should accompany any application for registration or renewal under the Article 3 (d) of the Piercing and Tattooing (Jersey) Law 2002.
Nursing and Mental Nursing Homes (General Provisions) (Jersey) Order 1995; Residential Homes (General Provisions) (Jersey) Order 1995; Nursing Agencies (General Provisions) (Jersey) Order 1978
The fees prescribed under the above Orders are normally increased annually by 2.5% in line with States policy. The Health and Social Services Minister has determined, subject to approval from the Treasury and Resources Minister, that the following fees should be charge for 2016 registrations, applications and renewals.
Table 2:
Residential Homes (General Provisions) (Jersey) Order 1995 amended | 2015 fee as currently charged | 2016 fee to be set out in updated Order | Percentage of the Increase |
Registration of Person in Charge - Article 3 | £79.18 | £250 | 215% |
Registration of Person Carrying on the home - Article 3 | £186.96 | £710 | 279% |
Annual Fee - Article 4 (1) | £95.48 | £361 | 278% |
Nursing Agencies (General Provisions) (Jersey) Order 1978 amended | | | |
First application for a licence – Article 2 (2) | £272.65 | £710 | 160% |
Renewal of a licence – Article 2 (2) | £134.66 | £361 | 168% |
Transfer of licence to different premises – Article 2 (3) | £107.08 | £200 | 86% |
Nursing Homes and Mental Nursing Homes (General Provisions) (Jersey) Order 1995 amended | | | |
Registration of Person in Charge - Article 3 | £79.18 | £250 | 215% |
Registration of Person Carrying on the home - Article 3 | £186.96 | £710 | 279% |
Annual Fee - Article 4 (1) | £95.48 | £361 | 278% |
Proportionality of fees: Whilst the 2016 % fee increases are significant it needs to be noted that:
• the total fees incurred will remain significantly below those incurred by comparable business in the UK (see below);
- whilst the 2016 fee increases help met the additional costs incurred by the shadow Commission they do not cover the full cost of regulatory services provided to nursing agencies and care homes, the rest of which are borne by the States of Jersey;
• the daily costs, when presented as a daily rate, are minimal. For example, the annual fee per care home and nursing agency licence renewal equates to only £0.98 per day.
Table 3: UK fees and charges
Care Homes | Initial Registration | Annual Fee |
Scotland | £3, 842 | £157 per bed |
England | None | £276 - £13,838 |
Nursing Agencies | | |
Scotland | £1,262 – £2,798 | £676 - £1,476 |
England | None | £796 - £35,403 |
The Health and Social Services Minister requires the Law Draftsman, in drafting the Health and Social Services (2016 Fees) (Jersey) Order 2015, to bring forward the necessary changes so that fees as set out in Table 2 above can be applied for 2016.
Fees beyond 2016
The fee increases set out above will be brought forward under existing legislation relating to the regulation of care. At the point at which the new Regulation of Care Law comes into force, an entirely new fee structure will be introduced. It is anticipated that this structure, which has yet to be developed, will see fees incrementally increase over a five year period until they are broadly comparable with the UK fee structure.
Consultation on 2016 fee increases
In July 2015, relevant providers, managers and practitioners were advised by letter of the proposed changes to the fees and offered an opportunity to meet with officers to discuss any concerns.
Letters were sent to 56 care homes, 66 piercing and tattooing premises and 80 registered piercing and tattooing practitioners. Response was limited.
Eight people attended the meetings; two from the care sector who understood the need to increase the fees but expressed concern about future cost pressures on the sector. Six represented the piercing and tattooing industry, two of whom acknowledged the need to apply charges and four who disagreed with the proposed level of fees.
In addition correspondence was received from:
• the British Acupuncture Council, raising concerns about piecing and tattooing fees being applied to acupuncturists; and
• two care sector providers who raised objections to the care home fees being increased.
- Recommendation
The Minister for Treasury and Resources is recommended to:
- approve the fee increases as detailed, above the 2.5% anti-inflationary target to support the establishment of a Care Commission.
The Health and Social Services Minister has responsibility for care regulations under existing legislation including responsibility for raising fees by Order. The Chief Minister has responsibility under the new Law including establishing the Commission. The Health and Social Services Minister has therefore agreed to increase fees levied under current legislation and transfer the increased income to the Chief Minister’s Department (CMD) in order that the Commission can be established.
- Reason for Decision
The States, in adopting the Anti-Inflation Strategy (P.125/2000), agreed that increases in States charges should be limited to a maximum of 2.5% a year, with any exceptions, in extremely compelling cases only, to be subject to prior approval by the Minister for Treasury and Resources.
The Regulation of Care (Jersey) Law 2014 provides for the establishment of a Health and Social Care Commission to oversee the regulation of health and social care activities on the Island. The Commission must be appointed in shadow form before that Law can be fully implemented.
The Health and Social Services Minister has responsibility for care regulations under existing legislation, including responsibility for raising fees by Order. The Chief Minister has responsibility under the new Law, including establishing the Commission.
The Health and Social Services Minister has therefore agreed to increase fees levied under the current legislation and during 2016 transfer the increased income to the Chief Minister’s Department (CMD) in order that the Chief Minister can establish the shadow Commission as set out in the Regulation of Care (Jersey) Law 2014.
The fees currently charged by the Health and Social Services Minister under the Nursing and Mental Nursing Homes (General Provisions) (Jersey) Order 1995; Residential Homes (General Provisions) (Jersey) Order 1995; Nursing Agencies (General Provisions) (Jersey) Order 1978 are therefore to be increased. In addition, registration and renewal fees will be levied for the first time under the Piercing and Tattooing (Jersey) Law 2002.
The fee increases as set out on the attached report are significantly more than 2.5% however they are still proportionate in that:
- whilst they help meet the additional costs incurred by the shadow Commission they do not cover the full cost of regulatory services, the majority of which is still borne by the States of Jersey;
- the fees for tattooing and piercing are comparable with the mid-range of fees charged by UK local authorities and the fees charged to other agencies and practitioners remain significantly below UK fees.
- Resource Implications
The 2016 fees, as set out, are intended to raise an estimated £27,999 more income in 2016 than was raised via the fee income in 2015. It is anticipated that in 2016, the costs associated with setting up and running the shadow Health and Social Care Commission will be £27,770.
Report author : Senior Decision Support Officer | Document date 11/11/2015 |
Quality Assurance / Review : Head of Decision Support | File name and path: L:\Treasury\Sections\Corporate Finance\Ministerial Decisions\MD-TR-2015-01xx – Fee increases to support establishment of a Care Commission |
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