Empty speech: Mr Seale on the regulation of counsellors and psychotherapists

Last year, April 2009, an interview with Marc Seale was published on epolitix.com, the first question had two parts. It was a very clear and direct question:

Question: Why has the government decided to bring in statutory regulation for the so-called 'talking therapies'? Does the HPC believe that regulation is necessary in this field?

The response given by CEO Mr Marc Seale is vague and evasive and says almost nothing; lets take it line by line to find something more substantial to say: "The purpose of regulation is to protect members of the public"

This line has never been substantiated - there was no research of any kind - good bad or indifferent - to establish the level or nature of danger that existing practices represented. This major lack leaves us all staring at the repetition of a political statement which we are supposed to swallow whole. The lack of any kind of objective or realistic benchmarks also mean that no proper judgement will every be able to be made about improvements effected by HPC regulation. We will be left in the domain of politics. At the last meeting of the HPC Professional Liaison Group for Counselling and Psychotherapy (12 May 2010) one of the professional members said it would be necessary to offer something more tangible to critics about the way that HPC is able to give better protection to the public. He implied that very few people would be satisfied with a bland repetition of the party line. The reply came quickly from HPC Chair Dr Anna van der Gaag who said: "we offer statutory regulation". For her, the mere presence of parliamentary power is sufficient guarantee of public protection. This is simplistic twaddle at best, and there can be few who believe it, even if there are few who are prepared to say so.

Mr Seale's next sentence is: "The government has indicated that it wishes to bring in statutory regulation for a number of the 'talking therapies' including psychologists, psychotherapists and counsellors"

Yes, we can find this wish written into the White Paper (Trust Assurance and Safety, 2007), but we can find no reason or rationale written alongside it. From the context of the White Paper the common knowledge is that politicking behind the scenes by the economist Lord Layard and his allies (who came together as the 'Savoy Conference') persuaded the then government to invest £170m in some kind of 'talking cure' provision in the NHS in order to save spending on Incapacity Benefits. That Government swallowed the maths, but could not justify giving money to people who were outside its control. Hence the intention to put Counsellors and Psychotherapists under the HPC (the great irony is, however, that the people actually employed to bring about this miracle cure were all outside this established field of expertise! The only winners seem to have been those few who won the training contracts...) Until that point all the major professional groups in the field were adamant in their rejection of HPC as their regulator. With the promise of nice jobs in the NHS they capitulated. Some people might call this bribery.

Mr Seale continues: "These professions account for a large number of practitioners and there is currently no compulsory requirement for registration."

The joke is that since the 1970s psychotherapists have been traipsing along to government offices asking for statutory power to be given to them, in order regulate the field. No government has ever agreed because the field is so diverse. If one pays attention to reality and to history we can see that, yes, there are a lot of people practising in this field, and no, there is no compulsory requirement for state registration. Further, we can understand that, until now, this has never been sufficient reason to hand over statutory power. What is not said here is that almost all the practitioners in the field belong to organisations that perform a regulatory function. Most people want to belong to a community that supports their work. Mr Seale seems to imply that without some kind of external force, practitioners would skulk around in the semi shadows doing things that weren't quite right.

He goes on: "Statutory regulation means that practitioners have to be registered in order to practise, demonstrating that they meet clear standards for their conduct and competence."

There it is, without the HPC, practitioners would not meet clear standards. Now, setting standards against which to judge the competent and incompetent has been the major difficulty of the professional liaison group at the HPC. As I have mentioned many times on this blog, HPC Council Member and Occupation Therapist Annie Turner repeatedly advised the counsellors and psychotherapists on the PLG to forget what actually happens in practice, and invent new standards to fit the HPC regulatory framework. She said that her own profession struggled for a long time before it realised that the Standards used by HPC were nothing to do with the actual practise they would police. The sentence from Mr Seale, above, suggests that the public will be better protected because now there are clear standards of conduct and competence. The advice of Professor Turner is that the actual technical competence of the practitioner is something that HPC is powerless to regulate. What standards, then, is Mr Seale talking about, and how will these standards help to protect the public? What kind of danger does he imagine he will be able to combat with the kind of standards that are invented to fit into his organisational framework? I have never heard or read Mr Seale give any kind of detailed response to these important and serious questions. He certainly doesn't give it here, in this EPolitix interview:

He goes on: "It also means that effective action can be taken in the event of a complaint." This is played like a trump card. Mr Seale’s organisation is, effectively, a fitness to practise factory, the raw material is the pool of registrants that legislation puts into the HPC database. More than one third of the annual income taken from registration fees is spent on the fitness to practise department, yet the proportion of registrants it processes is less than 1% of the register. 499 cases were considered by panels of the Investigating Committee in 2009-10. The number of registrants within the domain of HPC for this period was 205,000. That is 0.24% of all registrants presented a problem. Leaving aside for the moment the kind of problem these registrants pose, we are still left with the rather dismal statistic that of those 499 cases 30% were found unproven by the final hearing. So, out of 499 possible cases from which the public, apparently, needed protection, only 352 were found to be in some way problematic. So, this organisation, with its annual income of £16m managed to ‘protect the public’ from 352 practitioners last year. These figures simply don't support the claims Mr Seale is mouthing.

He says: "We believe that independent statutory regulation of psychologists, psychotherapists and counsellors is essential in order to protect members of the public." He doesn't say why, or how. For Mr Seale, it is sufficient to repeat the party line. At a conference in London on 23 January 2010 organised by Confer (and reported on this blog), Mr Seale was invited to speak to counsellors and psychotherapists about his proposals for regulation the field. His line throughout this meeting was that, "I am only a boring bureaucrat" "I'm just a man in a grey suit" "I just carry out the orders of the government". He consistently sidestepped his responsibility (valued at £180,000 per annum plus expenses according to the figures) claiming to be nothing other than an obedient servant of politicians. Mr Seale's job, however is as Chief Executive Officer and Registrar of an organisation with an income (levied through legislation) of £16m and increasing (but what is a registrar, what does he actually do?).

In the news last week (reported in the previous blog – HPC to capture Social Workers), the new Government seems to believe that Mr Seale is independent of government. How can we square these two things? If Mr Seale is only the obedient servant of the politicians, why don't the politicians know? Without someone taking responsibility here we are left with an organisation with statutory power to levy money from practitioners to stage show trials on behalf of employers (the highest proportion of 'complaints' come from managers in the NHS).

A second question posed by EPolitix last year was:

Question: There are parties who believe that the HPC is not an appropriate regulator for the psychology, psychotherapy and counselling professions, as your current models of regulation can not successfully be applied to non-medical therapies. How would you respond to that?

Mr Seale replies: "We are confident that our model of regulation works and is sufficiently flexible to allow us to regulate these professions. We are a multi-professional regulator and we currently regulate the members of 13 different professions including physiotherapists, paramedics and art therapists."

Again, Mr Seale avoids giving a proper answer to the question and simply states his belief.

He goes on: "Our registrants work in a variety of different contexts and many of our registrants do not work within the NHS for example, working instead in areas such as the prison service, education and industry. The professions we currently regulate also practice in very different ways and to different models, not just the medical model."

Mr Seale is trying to parry the arguments made against his organisation, but he does not engage with the issues (ie the problems associated with regulating such a generalised field). It is as if none of the words have any real meaning, but are simply the ones he has been given to string together into sentences in order to get by. It is as if he knows that he doesn’t really have to bother to think about things, as he has already been given the power.

Finally: "Strong professional input is vital to our model of regulation and we ensure good professional input through the use of 'partners'. Partners are members of the professions we regulate (and lay people) who provide the expertise and advice on matters of professional practise that we need for good decision making. For example, partners may be panel members who sit on fitness to practise panels that consider complaints about registrants, others may be registration assessors or visitors to education providers."

At the Confer meeting in January the counsellors and psychotherapists that I sat with in the afternoon's discussion groups were astonished to discover that the HPC chose and appointed the people from the profession who they wanted to work with. They had assumed that the profession itself would be better placed to know the best people for the job. Of course they are, but this is not what interests the HPC. The bias produced in the field by HPC policy is very troubling and has already caused much conflict and friction. It distorts the field in ways that have nothing whatsoever to do with knowledge and practice, and everything to do with the politics and power of the HPC. What Mr Seale means when he says 'good' and 'strong', then, depends on his own idea of what is good and true, it is a political argument, not a practical one where what counts as Good and True is defined by Mr Seale. The people that the HPC chose to work with were all people who consented to HPC regulation. Those who had strong reservations about the validity of HPC-style regulation were excluded from the process. Only when the HPC process was defeated (the 'public consultation' on HPC proposals last October provoked an unprecedented 1,000 responses and prevented the HPC from moving towards legislation before the collapse of the Labour Government) did any of those Good Strong people on the PLG start talking about taking the opposition seriously. HPC still don't think that would be necessary, however. Judging from Dr van der Gaag's chairing of the last PLG meeting (12 May 2010) HPC will continue their strategy of scare tactics by collecting together cases of complaints to insinuate that the field is full of sexual predators. This tends to close the gates on rational discussion very quickly indeed, and produces a push for punitive top down control.

Mr Seale has nothing to say for himself. He doesn't understand the work he is authorised to regulate, and won't accept responsibility for that gap in his understanding. There is a vacuum. Without an active thoughtful agent willing to engage with the void, he leaves it open to opportunistic and unpredictable forces. Such forces might have little to do with goodness, truth, or with protecting the public. Really, anyone would know that to make something valuable and worthwhile you have to make an effort, even (or especially) when power is handed to you on a plate.