HPC and the torture of language

The new government hopes to roll back the database state, but do they understand what generates it, or their own role in it?

I would point them to the problem of language and prescribe a dose of Lewis Carroll.

HPC agents often use language to mean whatever they want at any particular time. I have reported many examples from Di Waller’s chairing of the PLG for C&P. The HPC video on CPD is another great treasure trove of examples. But Chair Anna van der Gaag is also quite skilled at this game. She recently wrote an introduction to a new scoping report on existing research on complaints mechanisms commissioned by the HPC and called it a monograph. And this is odd, because, you know, the word has hitherto referred to a scholarly and original piece of work that contributes to a field of intellectual study and thus to the overall enlightenment of society – the Longman Dictionary defines it as ‘a learned treatise on a small area of learning, a written account of a single thing’. The report, no matter how well executed is not a monograph. The stuff in it, no matter how elegantly writ, hardly constitutes the ‘evidence base’ on whose back van der Gaag wishes to advance her expansionist cause.

Who benefits from finding out how to get more people to complain? The report is quite clear in its conclusions. People seem to complain for some unspecific reason that has more to do with standing up for a little bit of truth. Very few people actually want compensation, or to cause trouble, or to break trust. They seem simply to want to be heard.

Will these people be helped if the HPC makes it easier for them to complain? No. The complaint may well trigger a process, but this is an HPC ‘fitness to practice’ process applied to the standardised conduct of a specific individual. The scoping document gave no reason to believe that the information from existing complainants had much to do with this. Secondly, the vast majority of complaints received by HPC are received from employers or other professionals, not from members of the public.

‘I weep for you, the Walrus said, I deeply sympathise, through sobs and tears he sorted out those of the largest size, holding his pocket-handkerchief before his streaming eyes.’

The beneficiaries of this peculiar FTP process are the HPC which turn cases into statistics to prove to Privy Council that they are doing a job; the barristers who receive the fee for pushing the case through to its administrative conclusion; and employers, who avoid having to deal with the problems that arise in their own back yard. None of this has anything to do with increasing the country’s intellectual capital or adding to its programme of enlightenment.

I’m reminded of the monetisation mania preached by Mrs Thatcher and her minions.

Anyway, the report is not a monograph. It is, as it says on the cover, a scoping document that scopes a possible field of colonisation for the HPC. It is commissioned as a kind of market research. Come on.

The HPC newsletter ‘In Focus’ has been pinging into my mailbox for nearly two years now and is dull as ditchwater. It used to list the FTP cases and often provided a little case study of how practitioners were messing up. Since October 2009 however, (Issue 25), the FTP cases have disappeared, and since June (issue 23) the In Focus front page has been given over to the problem of cajoling people into making their renewal on time. Every single issue from 23 to the current issue (29) exhorts registrants to renew their membership on time. How interesting. Supplementary news items tend to report the rate of renewal achieved, and suggest that you encourage your colleagues to renew and put posters up in your consulting room. There is also a regular little line or two thanking the personnel managers and union reps that have helped to round up the registrants and corral them into the pen. Great stuff.

Also regularly featured over the last year are the ‘listening exercises’. Like me, you probably imagine that a listening exercise is where the HPC listen to the views of its various constituents – a kind of corrective to the lack of democratic procedures associated with this kind of organisation. WRONG! These events are for YOU to listen to the HPC. They are undertaken in order to tell you what you need to do to comply with their CPD and FTP procedures. It should come as no surprise that lots of people attend these events (all hopping through the frothy waves, and scrambling to the shore), for if they do not comply they will surely lose their livelihood.

For all its literary faults, the current issue of In Focus does, however, give another wonderful example of the insidious spread of the database state.

On 1 July this year the contentious vetting and barring scheme comes into force. This caused quite a splash when Philip Pullman and other authors objected to being treated as potential paedophiles. The objections were heard, but no one grasped that the scheme itself was where the problem lay. Politicians unwilling to admit they might be wrong simply reduced the volume surrounding the idea but didn’t change the record.

The vetting and barring scheme is designed ‘to ensure that everyone working or volunteering to work with children or vulnerable adults is suitable to do so by being checked and registered’. This law defines a vulnerable adult as any adult receiving healthcare. Health care. This word has been subject to so many twists and turns over the last year or so as the Health Professions Council seeks to define just about everything as health in order to incorporate it within its remit that we can see how the logic of this silly discourse will press everyone to sign up to this pernicious system. Instead of seeing the flaw in the system (a replication of agencies all trying to save the public from itself), the HPC views the VBS database as a potential competitor for the services it provides itself! I quote:

‘…the majority of HPC registrants will need to be registered with the V&B Scheme. … However registration with the VBS will not be a requirement of registration with HPC… Registration with the VBS does not replace HPC registration… The HPC will continue to set the standards for practising in one of the professions it regulates and you will still need to be registered with the HPC if you use one of the titles we protect.’

As the government continues to broadcast scare stories about how little money the country has, and how awful things are going to be, I suppose we cannot expect those employed to administer these various databases regimes to willingly acknowledge that the work they are doing is worse than a waste of time. The money they waste is not raised by direct taxation, but by a kind of stealth tax levied directly on their registrants (who have no right to vote on the way this money is then used). The accompanying discourse of security assumes the population is probably guilty, and punishes it by making it pay for the computers and offices and administrators in these little database states. Is this the kind of thing that politicians would ask seven maids with seven mops to spend half a year sweeping clear?

I doubt it, said the Carpenter, and shed a bitter tear.

Andrew Lansley replied to Esther Hague, the physiotherapist caught in the CPD trap. Basically he told her that the HPC is independent from the professions it regulates and from Government in order to function fairly and effectively, and he is therefore afraid that it is not possible for the Department of Health to intervene in this matter. He also said:

“Section 28 of the NHS Reform and Health Care Professions Act 2002 gives me as Secretary of State the power to make provisions in regulations for the Council for Healthcare Regulatory Excellence (CHRE) to investigate complaints about the way the nine health professions regulatory bodies have exercised any of their functions. However, Section 28 has not yet been enacted and the CHRE does not, therefore, currently have any statutory power to take action on the complaints it receives.

“The purpose of the CHRE is to promote good practice in regulation and consistency across the nine healthcare regulatory bodies. In the absence of formal powers under Section 28, the CHRE can work with the regulatory bodies only informally and consensually on the complaints they receive."

So, there you have it, says Esther. The powers of the HPC are totally unchecked. With regards to her concern about the linking of CPD with re-registration or a refusal to re-register if the arbitrary standards of the HPC are not met, Nick Clegg (her MP) has written to the CHRE to raise the concerns with the Chief Executive.

“So”, she says, “we go round in circles.” But she hopes that Nick Clegg is beginning to recognise the unchecked powers of the HPC and says she is determined to take it further with him “to get this culture of mistrust and excessive regulatory powers of the HPC brought out in the open and hope that the new government will see the negative effect this has on health professionals”. Way to go, Esther.

The union now known as Unite has set up a National Occupational Advisory Committee for counselling and psychotherapy. Meeting Wednesday, 29th September 2010. Vacancies still exist for: Wales region, North East/Yorkshire and the Humber, Ireland, Eastern, East Midlands. You can email me for more info.