Regulation in a complex sector such as healthcare presents a dynamic set of challenges. Complexity is integral to life sciences: the ability to do great good is finely balanced against its inverse. There are also inescapably human factors: human nature itself (that of both providers and patients) and potential for error.

Regulation of any kind is essentially policing — it relies upon on the consent of the regulated. It also requires respect. We should perhaps be honest that in life sciences, few regulators are loved: that is probably not their fate. A few are hated and collapse into chaos (see the Care Quality Commission or the Nursing and Midwifery Council in healthcare); most are grudgingly tolerated and a few are respected. 

Across the life sciences, self-regulation through royal colleges or Parliament-mandated bodies, such as the General Pharmaceutical Council (GPhC), seem to be the only bodies that the professions will accept.

The trade-off is that their membership and examination fees will keep the cost and burden of self-regulation off the public purse, in return for adequate professional self-policing and roles as national voices. 

The 12% solution

The GPhC has a problem: it is about money, but it is not only about money.

As The Pharmaceutical Journal recently reported, the regulator “has opened a consultation on proposals for registration fees to increase by 6% in 2025, followed by a further 6% increase in 2026”.

The GPhC said the fees were needed “to cover rising operational costs and to make sure that the GPhC can continue to fulfil its regulatory responsibilities effectively”.

Under the proposals, from September 2025, pharmacist renewal fees would increase by £17 to £293, pharmacy technician renewal fees would increase by £8 to £138, and pharmacy premises renewal fees would increase by £24 to £416.

“Following the proposed further 6% increase in fees, from September 2026, pharmacist renewal fees would increase by £17 to £310; pharmacy technician renewal fees would increase by £8 to £146; and pharmacy premises renewal fees would increase by £25 to £441,” the story said.

I quote this story extensively to draw readers’ attention to what it will mean in cash terms. The national battle against inflation is far from won: it currently sits around 2.5% and is believed to be rising, stymieing the Bank of England’s previously-presumed scope to cut interest rates further to support UK economic growth, which seems to remain sluggish. Inflation causes government debts to seemingly shrink but is generally bad for individuals on a cost-of-living basis.

The GPhC is asking for an increase of more than twice current inflation, two years in a row. In the immortal words of Oliver Twist: “Please sir, I want some more.” 

It is seeking to play catch-up, in an ironic echo of the recent pay disputes among UK NHS medical staff.

The proposed rise is justified on the basis of inflation and suggests that the GPhC will have to cut back on its regulatory work if it did not increase fees.

Numbers are up

It is certainly the case that, as its statement notes, the GPhC has been dealing with a “significant increase” in fitness-to-practise (FtP) cases, as well as a large backlog in cases since the COVID-19 pandemic, “which has increased workload and costs”.

Let’s look at each of those points in turn. As The Pharmaceutical Journal observed, in September 2024, the Professional Standards Authority (PSA) failed the GPhC on its standard for FtP timeliness for the sixth year in a row, saying that it was “taking too long to progress FtP investigations”, while also acknowledging that there had been a “30% year-on-year increase in FtP referrals received [by the GPhC] since 2022”.

Untimely FtP investigations are widespread in the field of life sciences professional regulation. In August 2024, a feature written by The Pharmaceutical Journal‘s news editor Graham Clews and investigations editor Sophie Willis looked at the scale and scope of this issue for the GPhC.

In January 2025, Roz Gittins and Dionne Spence, chief pharmacy officer and chief enforcement officer at the GPhC, respectively, wrote for The Pharmaceutical Journal about the GPhC’s efforts to improve FtP inspections and processes.

While this makes fair points about the time that legal processes take, you also do not have to read very far between the lines to see that these two individuals inherited an FtP system that was evidently not working adequately, and had not been for some time. That is firmly on the GPhC’s internal quality control processes. 

The COVID-19 red herring

On the GPhC claim that the COVID-19 pandemic increased its case backlog owing to “increased workload and costs” — I’m sorry, what?

There was little of professional activity overall that did not have to move online during the pandemic. If actual law courts managed it reasonably effectively, it is not at all clear why the GPhC could not have done so for FtP work. This is a completely bogus excuse.

Finally, the GPhC’s article also mentions “the much-awaited update to guidance on providing pharmacy services online” as one example where “having focused on improving internal ways of working in 2024, we are hopeful that in 2025 our improvements will be felt more, externally”.

Online pharmacy is not even vaguely new. Pharmacy2U began operating in 1999. It is unclear that the actual regulatory issues can by 2025 be in any way novel or surprising. The GPhC has had 25 years to get up to speed with this.

Regulation is a legal process, which gives the terms of references for a conclusion. The case for these rises might be acceptable on the balance of probabilities, but it is certainly not proven beyond reasonable doubt. If I were a pharmacist, I would want to be very confident that the GPhC was thoroughly reforming its internal processes and procedures before I would be content (probably grudgingly) to give them this catch-up cash.

Andy Cowper is the editor of Health Policy Insight