Independent healthcare fees: consultation analysis report

Introduction

The providers of independent healthcare in Scotland are many and varied, and the complexity of this area of healthcare provision continues to increase. Healthcare Improvement Scotland (HIS) are responsible for regulatory and inspection functions in relation to independent healthcare services as defined by legislation, currently including independent hospitals and clinics led by healthcare professionals. The fees HIS charge are detailed in statute (see Annex A for fee breakdown) and the maximum fee level is prescribed in regulations by the Scottish Ministers. The Scottish Government believe fees should be fair and proportionate, taking into account the required reasonable expenses incurred by HIS in carrying out its functions when setting fee levels.

The initial costs of registration for HIS are broadly similar, regardless of the type of service or the size of the business being registered, as the level of resource within HIS needed to assess an application does not vary significantly depending on the sector within which the service operates or its size. However, once registered, the level of regulatory input and risk a service presents is reflected in its continuation fees.

Both the Scottish Government and HIS are currently involved in ongoing discussions around the regulatory framework for independent healthcare services, including fees that are being charged, as it is recognised that the maximum fee structure was set a number of years ago when the independent healthcare sector in Scotland was less diverse and complex.

In early 2023 we ran a public consultation which asked a number of questions about the regulation of independent healthcare. Responses showed strong support for further regulation in this area, as well as supporting proposals that include regulation of independent clinics where services are provided by pharmacists and pharmacy technicians, and for regulation of independent medical agencies which will include wholly online services based in Scotland.

The purpose of this consultation (from October to December 2023) on independent healthcare fees was to gather views on the proposed increase to the maximum fees that HIS may charge.