PLG: structure of the register - the call for ideas

The call for ideas - what is it? Part of the process of HPC-ification is to convene a Professional Liaison Group, who will discuss the issues and come up with a proposal. However, in order to avoid accusations of partisanship, there is a big effort to show how open to other ideas they are. The Call for Ideas is one way of presenting the image of openness. Another way is to hold the meeting in public. A third way is to hold a Stakeholders meeting to feed back to a wider group and even to take more comments (scheduled for March in Manchester). It reminds me of 'iteration' carried out by information system designers that I studied in the early 90s. High level policy makers made the decision to centralise knowledge and computerise processes, and engaged Anderson Consulting to help them to do it. A set of people called systems designers went out to discover how the work was being done, came back to the office to encode it into programmes, then sent the change management guys out to take the flak and find out what kinds of problems would need to be overcome when rolling out the new system.

Calling for ideas is a wonderful way of discovering the opposition. It is also a wonderful way of saying that you've consulted widely and listened carefully. But it is not a good way to conduct research, to make an analysis of the situation, and to think through unintended consequences.

The government has already decided that psychotherapists and counsellors constitute a threat to the public, but has not troubled to say how. It has already announced that they shall come under the regulation of the hpc. The government has also stipulated the structure and nature of the hpc in so far as it is able. It is a top down political decision that is enmeshed in a process of law. It is not an enquiry in the scientific spirit of enlightenment - it has no real interest in discovering how best to set things up so that the practice, the patient, the punter, the practitioner are operating in the best of conditions.

Right at the beginning of the meeting the Strathclyde Professor asked the sensible question: what is our role, what are we trying to do? The chair responded: to look at the arguments, to debate, to think, to say what we believe for reasons of public protection, to sketch things out, not hard and fast, but to give three main proposals for the structure. The HPC panel member representing physiotherapists added: it is not necessary to come up with a definitive decision, and the chair reiterated, 'yes, keep it vague, come up with a sketch'. Another HPC panel member, this one a lay member, added 'we aim to favour a model, but we know that it may change'. In the first meeting of the group it had been made plain that the role of the PLG was to recommend something to the HPC council who would propose it to the DH who have a team of writers to turn the proposition into law, should the government agree.