“We set the standards ‘you’ must meet.” The HPC new generic standards. Pt 1

The HPC’s latest In Focus magazine (Issue 30) contains an article preparing the ground for their five yearly review of standards. The chief concern of HPC in this project is to produce an ‘overarching’ set of standards to apply to everyone that might come under their control. These new standards will be analysed in more depth shortly. Analysing the text of this one page introductory article from In Focus reveals a number of important points – the title of this blog is one of them that rather speaks for itself. The rest are fragments from the text with a short discussion of each:

1. “There are separate standards of proficiency for each profession we regulate.” It is interesting to note that the HPC deem it necessary to include this statement rather than leaving it as read. It suggests they find it remarkable that it is still the case. The article here is concerned with a new set of standards that will be the ‘overarching’ standards which the 15 different professional standards will have to subordinate themselves to. This is a fabulous example of top down control and ignores the particulars of practice and implicitly over-rides any appeal to science or even common sense. The standards of the HPC do not flow from the actual work, they flow from a centralised committee and an amorphous public consultation. The HPC has been set up on the understanding that it can regulate without needing to know anything about the practice under its control. Each new profession captured by the HPC will make it even more difficult to attend to the diversity amongst practitioners, and cannot help but set up a pressure to reduce these distinctions to make it easier to manage. This pressure will force standards further and further away from actual practice, and closer and closer to moral or political requirements – the less interested the Regulator is in real work, the more interested it will become in its own thoughts and ideas.

2. “Your practice will develop over time, and you may find that you no longer meet all the standards of proficiency for your profession. This is not a problem.” This is from paragraph 2. Let me just quote from paragraph one: “We set standards which ‘you’ must meet, both to gain entry to the Register and to stay on the Register.” How are these two sentences to be reconciled? There is a loophole here through which different degrees of power can easily enter surreptitiously.

3. “Your service users will expect you to meet high standards of personal conduct”. This is a curious statement and seems more interested in creating a class above the rest. Why would you expect, say, an art’s therapist to have higher standards of personal conduct than yourself or, say, your postman? Also, how does the HPC know what ‘service users’ expect? There is no reference to any research which might be consulted. And of course, let us not forget that the phrase ‘service user’ is a politically correct euphemism for ‘patient’, and is incredibly unspecific (one HPC document says it refers to anyone who might know someone who comes under the care of someone on the register) a phrase which has gained currency over the last decade and which perpetuates a misunderstanding of the basic properties of language - there is no implicit moral order in the word patient which, etymologically at least, designates someone who is suffering. HPC standard setting seems to be more interested in ideology than practice. This makes it more a tool for cultural change placed in the hands of bureaucrats.

4. CPD. This requirement was brought in with Patricia Hewitt’s White Paper (Trust, Assurance, and Safety, 2007). Continuing Professional Development is a phrase that belongs to the audit culture ideology and provides the basis for commodifying knowledge and selling training courses for which certificates of attendance are now routinely produced only to be inserted into CPD files and shown to people at the HPC (and their ilk). The HPC boldly state that ‘CPD is the way you continue to learn and develop throughout your career so that you keep your skills and knowledge up to date and are able to work safely, legally, and effectively’. This, however, is a belief, not a fact. In order to substantiate the belief the government have enacted a law which has led the HPC to construct an elaborate ritual where 2.5% of registrants in a particular profession are ordered, at pain of being removed from the register, to fill in a form which proves that their CPD has done what the HPC say it does. HPC have appointed and trained Assessors (‘at least one of whom will be from the same profession as you’ proclaims the booklet), to read these forms and reject any that don’t prove the hypothesis. One physiotherapist was told that one lay-person and one physio looked at her return. She had been assured that the CPD she undertook was her business, as a professional. However, when she filled in the forms and sent them in she was surprised to receive a further communication from the HPC asking her to prove that her CPD was benefiting the service user: “The Standards could be met if the registrant can show links as to how her CPD activities within the registration period have improved her work and benefited the service user." We don’t know whether these are the comments of the lay-person or the professional, but we can find the idea written into the document that accompanies this process (downloadable, of course, from the website). It appears in between two ‘standards’ which have been created by a committee and a consultation process. One standard says ‘a registrant must seek to ensure that their CPD has contributed to the quality of their practice and service delivery’. Another says ‘a registrant must seek to ensure that their CPD benefits the service user’. The reference point has become one from business and has broken away from the rational basis of thought. This is no doubt a result of distributing ‘thinking’ over a disparate group of people none of whom can be held accountable for the consequences of their thoughts. The law of the land then pulses through this mish mash and gets imposed on real people who were otherwise busy getting on with their work. This particular physiotherapist is now very worried that the HPC might remove her from the register, and render her practise illegal, because she cannot prove that her CPD has improved the quality of her service to users! It makes her sound like a poorly functioning factory unit.

Incidentally, the administrator at the HPC is called The Customer Service Manager. Who is the customer here? Apparently the HPC think it is the registrant. However, the registrant, as we all know, is compelled through force of law to pay money to the HPC. There is no service supplied in return. They pay for the right to practice their trade (which was their right before the invention of the HPC). It would not be unreasonable to see them as a tax-payer except that this would require you to understand the HPC as a small state, and to acknowledge that in this mini-state there is taxation without representation.

And what would a lay-person have to offer to the process of assessing the CPD return of a practitioner about which they know nothing? The only thing that seems possible is that a lay person might have the kind of common sense that sometimes goes missing amongst people who know too much about something, and might therefore be helpful to ground a conversation. But the process hasn’t been set up as a conversation, and the situation has not been rescued – it is profoundly un-grounded. The lay-person, rather than one person amongst a group of professionals, is one half of the team that assesses the forms returned by the professional. If this example is typical, then apparently the comments of the assessors aren’t mediated by anyone in contact with reality, but are simply returned to the registrant with the implicit threat that they will lose their right to work. The reasoning, if such it be, behind putting lay people into this process can be traced to the lack of trust the politicians have in the professions who do the work. Remember that peurile advertising campaign that launched the HPC? It encouraged the public to doubt the veracity of the professionals' word. Pernicious stuff.

5. “We use the standards we set whenever we make a decision about [‘you’]”. This statement is nothing more than an alibi. The standards are so vague (we will come to them in due course) that they can be used in wide variety of ways (as we have seen in some of the fitness to practice cases). The HPC are using the Standards as a pseudo objective written document to justify the power they have to stop someone from working. But because the standards are so far removed from actual practice, there is nothing real to help to ground the process of judgement, which leaves the whole thing open to politics and ideology or whim. This will feel like ‘bullying’ by anyone who is unfortunate enough to be in the way. There is no reason or rationality that can be appealed to in order to ameliorate the experience of the power.

6. “As an autonomous and accountable professional, you are responsible for the decisions that you make and must be able to explain them [to us].” There is a contradiction in this that expresses an impossible wish – like that of the child who wants to know something without the having to expend the time and effort it takes to learn. A responsible professional can be expected to account for him or herself to someone who works in the field, who understands the work; an excellent teacher could explain the work to someone who actually wants to know something about it. But why should all registrants now be expected to be excellent teachers, especially when the relationship of teacher pupil is totally inverted through the misapplication of institutional power? Furthermore, by insisting that knowledge be reduced to easily digestible chunks the HPC adds to the commodification of knowledge and interrupts the natural process of transmission and acquisition that traditionally supports a community of practitioners. If that weren’t bad enough, this highly centralised system cannot possibly benefit from the knowledge it produces, anything of value is simply discarded as the process transforms into a method of judging the quality of product in an imaginary factory. The practitioner is transformed into the product.

7. “[Our] Flexible standards give you the opportunity to grow and develop within your scope of practice”. Says who? The willingness of the HPC to say whatever it wants is truly breathtaking. There are no checks and balances.

8. “[Our Flexible Standards] also allow you the opportunity to make your own decisions based on circumstances”. The wording of these statements clearly communicate that the HPC is the overlord by whose grace you, the professional, are granted permission to work. Without this permission you would not have the opportunity to make your own decisions. The HPC, remember, knows nothing about the practice, and delegates big decisions to a few hand picked professionals held in a centralised system, and (in the annual consultation jamboree) to the public at large, over whom no quality control is exercised.

9. The following statement is another great example of the way the HPC insinuate that there is a danger lurking out there that they can protect you from: “You may be placed in a situation where you are worried that something you have been asked to do, or a policy you have been asked to follow, may mean you cannot meet our standards. You may also worry that this will affect your registration. We cannot give guarantees about the outcome of every situation. However, if you make informed, reasonable, and professional judgements about your practice, in the best interests of your service users, and you can explain the decisions that you made if asked to, it is very unlikely that you would not meet our standards or that your registration would be affected.” This does nothing to reassure but is vague and suggestive, it insinuates that you can’t cope in the world without them. It is infantalising.

10. “We would welcome any comments you may have about this article of any suggestions of topics for the future”. There is no promise that thought will be given to any comments that criticise the article - the CEO (Mr Seale) has said he will 'just take on the chin' any criticisms that come his way. Judging from the way that previous comments have been dealt with by his staff it is to be expected that only comments in support of the HPC’s self image will be given any credence.

11. “Next time we will look at whistleblowing and raising concerns.” Unfortunately, nothing productive will be done with any concerns, they will simply be turned into grist for the mill in this 'ecological' disaster.