Confer Conference, Saturday 23rd Jan 2010 (Part 1)

Saturday’s Confer Conference on HPC State Regulation brought together the figureheads of key clans active in the UK psy field today.

As we know, clan HPC is not a native psy organisation, but seeks to take control of the practice in order, as it says, ‘to protect the public’. This clan draws its power not from practice or philosophy, nor even from any pressure group or union, but from the Government. It holds a veil over this relationship.

Ultimately, the relation HPC seeks to build is with the individual members of the 50 or so clans in the psy field, yet initial negotiations take place with the leaders of a few of the more powerful tribes. It is with the individual members that the long-term interest of the HPC lies. This is where the tax will be levied, this is where the new rituals of engagement will be played out, this is where the power will be applied. HPC estimate it will ‘capture’ anything between 50,000 and 100,000 members in this new arrangement.

The money raised from the annual levy will pay for the offices, the salaries, the equipment etc etc etc, of the HPC clan, which retains almost absolute control over decisions how to spend it.

There are virtually no mechanisms whereby the members, or registrants as they are known, can call or hold this regulator to account.

As we have already discussed, and as Italian Barrister and Psychotherapist Alex Amicarelli has exposed, the HPC has been put into a position of power by the Government, but without any obvious mechanisms to call forth its responsibility. Like Shakespeare's Measure for Measure, the Duke carelessly hands power to the rectitudinal Angelo then clears off out of the public eye. This fudge makes it possible for the HPC and its supporters to say whatever they like, depending on what is needed to win the argument at any particular moment. The position it holds is the symbolic key that guarantees its immunity.

It is helpful to think in these terms when reading the extraordinary document that the Conference organisers encourage conference participants to read in preparation for the meeting. In Marc Seale’s statement, for instance, we find just two short paragraphs (presented, by the way, for no apparent reason in quote marks). These reveal the sophistication that is necessary to deploy from a man in such a position. In the first paragraph Marc states that Statutory Regulation will make Psychotherapy and Counselling safer. And in the second paragraph he states that HPC regulation has no negative effects.

The position statement issued by the British Psychoanalytical Council, is a little longer (5 pages), but bears a similar declamatory tone. For example, on NICE: “We consider that the establishment of the National Institute of Clinical and Health Excellence (NICE) that carefully weighs the evidence for the effectiveness (and cost effectiveness) of treatments in the UK is an immense social gain.” But goes on to offer the contradictory information that “there is an issue around whether an overwhelming and over-simplistic primacy has been given to randomised controlled trials (RCTs)”. There is no attempt to analyse the conflict.

The BPC Statement pledges support for each area of Government policy – IAPT, NICE, SfH & NOS, and the HPC. It adds that it is also working with NIMHE and its new project NWW. Anyone who wants to know what these acronyms mean is obviously suffering from 20th century syndrome, and should report immediately to their nearest government re-programming centre, or download the do-it-yourself software (perhaps the link will soon be available on the BPC website).

The statements of Darian Leader (speaking on behalf of the Alliance for Counselling and Psychotherapy against State Regulation) and of Andrew Samuels (appearing in his capacity as Chair of UKCP) have yet to be posted to the website. Instead, you can re-read the original Alliance Statement of Intent, or plough your way through the UKCP’s response to the public consultation on the report of the Professional Liaison Group for Psychotherapy and Counselling produced for the HPC.

Also posted for your edification are the BACP response, the HPC Draft Standards of Proficiency, Michael Guthrie’s (HPC Director of Policy and Standards) assimilation of all 1,100 responses to the consultation, and the Government’s White Paper (Trust, Assurance and Safety). There is no mention of the Maresfield Report, nor a link to the Kings College report

For those who still have room for more reading you may be interested in the following background information, taken from evidence submitted to the Select Committee on Health in 2006. These excerpts come from evidence given on 15th June, 2006, by Marc Seale (CEO of HPC), Sarah Thewlis (Chief Executive of the Royal college of Nursing and Midwifery), and Finlay Scott (CEO of GMC). It is included here because it shows a couple of interesting features. First, the real pathway of accountability of the HPC, and second the way this emphasises the fundamental objectives of the government’s regulatory machine in the regulators mind.

The Chair of the committee (who himself happened to be a lay member of the GMC), kicked off by asking: “How are regulators helping to develop a workforce that is fit for purpose for the 21st century, as opposed to just developing more of the same?”
Sarah answered: “…by seeing regulation in its broadest context and not just seeing it dealing with unfitness to practise issues… but I think very much when you are working at workforce planning it is about making sure that people that come on to the register are competent… [and] we have worked very hard with employers about making sure that we can provide a flexible workforce”. [emphasis added]

Scott answered in exactly the same way: we have four functions, not just dealing with impaired doctors, but also “Standards, Ethics, Education and Registration, [which] all help us to contribute to the shaping of the workforce through influencing not only undergraduate medical education and training, but also the attitudes, the ethics and principles that doctors take to their work day by day and, as with the Nursing and Midwifery Council and other regulators, the very direct control over who joins our register from outside the UK and the EEA… we are ensuring that we fully involve representatives of the public, employers, and of course representatives of the profession, to try to ensure that the public's expectations of doctors can be reflected in the way that the doctors of today are educated.”

And Seale said: “The Health Professions Council also has a specific role in advising the Secretary of State of which new professions should become statutorily regulated, and that, I think, is vital in terms of protection of the public. I think the last thing is that all three of us have participated in the Foster and Donaldson Review and we are eagerly awaiting the outcome of that because I think that will that enable the regulators to be fit for purpose as we move forward into the existing century.”
When you look at the place from which the CEO is held accountable, and observe the methods of those who are actually empowered to challenge him, then you might begin to understand how the process gets so badly distorted.

Marc Seale had the last word in that particular sitting of the Committee. It is a little difficult to grasp, but revealing nevertheless. Here is what he said:
Mr Seale: “It might be useful to link this debate back to workforce planning. What is going on—and it is beginning to accelerate this change—is the traditional model of doctors, nurses and physiotherapists is beginning not to work, because I think what is happening is that new skills, new technology, new drugs, et cetera, start off in a very small group of individuals who are skilled in doing that and gradually that skill goes down through the workforce. At the same time you can actually now come into the workforce at a particular level with that new set of skills and what the regulators have to do is to capture those new individuals with the new skills as it trickles down through the system. Currently it is not quite working correctly but I think all the regulators want to see it work effectively. That will mean that as demands are put on the workforce those skills could then flow through the individuals.” [emph added]

Measure for Measure is at the Almeida from Feb 12th, to April 10th.
“To whom should I complain? Did I tell this, who would believe me?”