Playlet: PLG considers the serious questions raised by those who are concerned about the possible negative effects of regulation by the HPC

At the second meeting on the PLG (Professional Liaison Group) for Counselling & Psychotherapy, 28 and 29 January 2009, members were asked to consider the questions raised in the Call for Ideas (Oct 08) which were gathered together under the heading "Conscientious Objection". The arguments and concerns were condensed by administrator Michael Guthrie to a few lines, reproduced below.

Coincidentally, members of the PLG had also recently received a lobbying letter from the College of Psychoanalysts-uk, and a member of the public had placed copies of the Statement of Intent on the table from the Alliance for Counselling and Psychotherapy against State Regulation.

There were, then, a considerable number of objections, each laid out with substantial argument, presented to the PLG to consider. What follows is a small playlet, written from my notes made at the time (I was a silent observer at the back of the room), which presents the way these serious concerns were handled by the meeting:

First, the section from Michael Guthrie’s Summary of Responses to the Call for Ideas, Oct 08
3.2.2 (p37) relating to Conscientious objection.

Summary.
- The Register should be structured to provide for a list of 'conscientious objectors'. A list of 'non-licensed', 'non-certified' psychotherapists exists in the US State of Vermont.
More Information/points for discussion
- The PLG may wish to consider whether such an approach would be meaningful to either members of the public or the profession and achieve the public protection aims of statutory regulation. No known arrangement similar to that in Vermont exists in professional regulation in the UK


MICK: Is Principled Non Compliance a practical option in your opinion?

MICHAEL: I cannot foresee the government being able to accommodate it.

BRIAN: There is a possibility of several different registers springing up all simultaneously with HPC - have you thought of that?

MICHAEL: [nonplussed]

MARY: I’ve looked carefully at the arguments - that people choose willingly to go private and so on. But that’s the same with dentists, and they can do a lot of damage, or estate agents - they can rob you blind. If you are in a position where someone comes to you and you can do harm, then, well, I’m afraid I cannot support it.

ANNIE: Why are they asking the regulator to hold their names on the register if they don’t want to register and be regulated? You can’t have your cake and eat it too you know.

NICK: Are they the registered non-registered?

JONATHON: What is the purpose of regulation? Without statutory regulation people who are known to be harmful will continue to practice. People need to be prevented from practicing. Either it is the regulator or the law, and the law can’t be different for one person than another.

PETER: They could get taken off the Non Register

NICK: Or sent to Vermont

JULIAN: We must not ridicule them - they hold their position seriously, and hold it well.

JONATHON :Not ridicule, but put the facts. The evidence base is clear that there is harm. Best outcome of this process is the vast majority will continue to practice in the way they’ve done before, but bad practitioners will be removed. We have to come back again and again and again to the public protection issues. We are in a New World now. Professional led self-regulation is dead. The Health & Social Care Bill last year said there must be an equal number of lay people on the board as professionals.

PETER: I totally agree. These people - we should take a very firm view. Compared to other professions, psychotherapy is definitely potentially harmful. Five per cent of practitioners cause damage.
[voices off: says who - where's this published? what is the source the paper? what is the evidence? what grounds do you have for that? etc]
… The public is ill-served, the present situation is in-effective. We hope it will become more Evidence Based. A little bit more notice of what is known in general will lead to an improvement in client care. Registration is not new. The medical profession was against regulation. It is an urgent issue for public protection.

LINDA: We should not mock or ridicule these people. But, the public needs protection and therefore we need regulation. Professionals need protection too. I think it is a good move for the profession.

JULIAN: We are a victim of our own rhetoric. Public Protection - we are part of the public, the clinical community is part of the public. Care providers are vulnerable. The public is at risk from us, yes, but we are vulnerable to them too!

CARMEN: It is a philosophical position that these people are taking. It’s not about a ‘them’, there are several different groups. I would not choose the HPC if I had any choice.

JEFF: Other aspirant groups have had this problem.

DI (Chair): We have all been lobbied, lets be frank, but the letter is philosophical. They point to the confusion between State and Statutory Regulation, and raise the question of totalitarianism. [sigh] Look, I've lived in an eastern bloc country, oh, for many years, I know what totalitarianism is, and this is not that. It might look like it from the outside, but it doesn't feel like it inside the HPC. Also they talk of the medical model... No, no [shakes her head slowly from side to side] oh dear...

FIONA: We must take this seriously. They have a petition, and it had 1600 names on it at the beginning of the week, a lot of names on it that I respect. I’m not willingly part of this process. Perhaps I am willingly dragged into it, but only because I believe I decided I had to join in order to try to influence it.

VOICE: The HPC gives public protection. It protects the registrant. It helps with credibility. There is really nothing to do but pay the fee and gain status and credibility.

MARY: And upholding public confidence. It’s a matter of pride to have been recognised by the HPC, to get external validation.

DI: Oo, things are getting a little bit heated. Shall we take a short ten minute break and come back to finish it off?
....... [fade out… and back ]

DI: Right, now, we need to move on.

MICHAEL: Which protected titles do you want to have. We protect titles, rather than function, but we have to police mis-use of title, and we do that through the ‘intention to deceive’. If people don’t register, we won’t have public protection.

CARMEN: Registered counsellor, ok, but what about a registered life coach? I’m quite frightened by that. We need to look after, preserve, make clear, how to deal with the widespread use of the word.

MARY: If we think its right, we’ll do it, and ignore what goes on elsewhere.

CARMEN: If they are not doing it well enough, and they are using my professional title, well...!

MARY: [vehemently] We’ll get them on ‘if you go beyond your skills and competence’. [recovering herself] Prevention is the better protection of the public.

JULIAN: We’ve parked a difficult issue.

DI: But we can be seen to have done justice to the question.