1. Shadow Health Minister Anne Milton calls 3-hour meeting in The Grand Committee Room, Westminster Hall on 2nd November for major stakeholders in the regulation debate for counselling and psychotherapy.
2. Videos are now online from The Alliance conference on 11 October. Independent reports can be downloaded by clicking here.
3. Andrew Samuels is standing for election as UKCP Chair – click here for videos and reports on the process, and click here for the on-line discussion on the UKCP web.
4. BACP rejects the HPC Proposals for regulating Counselling and Psychotherapy.
5. The Maresfield Report published: a thorough analysis of the statistics and expense of the HPC Fitness to Practise regime. Legal challenge to HPC via the well-known London law firm Bindmans. NCP publish 72 page report 'Is HPC Legal' by Italian Barrister A Amicarelli
6. The Kings College and Royal Holloway study, 'Statutory Regulation and the Future of Professional Practice in Psychotherapy and Counselling' Funded by the General Medical Council and the Economic and Social Research Council – warn of over-regulation failing to provide the best model of patient care.
7. Compliance? Ambivalence? Rejection? A short book of responses to the HPC Consultation signed by 103 members of the Alliance Conference on 11 Oct was delivered to HPC on Monday 12th October, but no acknowledgement has been received.
8. A pamphlet by Arthur Musgrave containing ‘one half of a dialogue with enthusiasts for HPC regulation’ –a fascinating account of a serious attempt to enter a dialogue with those who are strongly in favour HPC of counsellors and psychotherapists.
9. Andrew Smith, Labour MP for Oxford East put a written question to the Department of Health (22 Oct) asking the Minister “If he will make a statement on the rejection by the British Association for Counselling & Psychotherapy of the Health Professions Council's proposed statutory regulation of psychotherapy and counselling.” The rather bland answer can be found by clicking here.
10. The House of Lords Select Committee on Merits of Statutory Instruments argues for less Government reliance on Regulations, in order to leave greater room for the professionalism of practitioners to deliver the objectives of improving learning.
11. 200 members now participate in the Alliance ning blog
12. AHPP (Humanistic Psychology Practitioners) advise members on strategies to avoid data transfer to HPC.
13. Regional groups continue to stage meetings to allow their members time and information to think with – a new meeting in Solent is currently being planned.
Monday, 26 October 2009
HPC answers some questions posed by Prof Andrew Samuels
"Dear Professor Samuels
Thank you for your recent emails. I have responded to each your questions in turn below.
1) How many people do you think will be registerable?
Estimates of numbers of psychotherapists and counsellors in the UK do vary by between around 40,000 (the approximate total of individuals on the larger professional bodies' registers / membership) up to around 100,000.
Reaching a more precise figure at this stage is difficult as it is hard to quantify the number of practitioners who may practise outside of the existing self-regulatory systems run by professional bodies and associations. In addition, at this stage it is also difficult to quantify how many practitioners are registered currently with more than one organisation.
I am sorry that I am not able to be more helpful in relation to this question.
2) How many voluntary registers do you think will be involved? How many are above 1,000?
We anticipate at the present time that the numbers of registers we will need to consider for transfer will number around the 30 to 40 mark. However, we may be contacted by other organisations who wish their membership lists to be considered for transfer and there may of course be further registers established or consolidation of registers prior to the opening of any statutory register, which would affect the overall figure.
I know that the registers / membership of the BACP, UKCP, BPC and BABCP all total over 1,000 members / registrants. However, we will know more once we begin the process of making recommendations about which registers should transfer early in the new year.
3) How do voluntary registers get transferred?
In order to introduce regulation for the first time, a Section 60 Order under the Health Act 1999 is required. This piece of secondary legislation has to be passed in Westminster and in Holyrood before the regulation becomes law.
The Section 60 Order specifies which registers will transfer to the statutory register and may indicate any arrangements that need to be entered into between the HPC and the holder of that register. This is a result of discussion between the Department of Health, the organisation and the HPC.
In terms of logistics, we would work with the organisation holding the register to establish the data they hold and compare it to the data we require for registration (name, address, data of birth, etc). The transfer of data would then normally occur electronically with security measures such as encryption put in place to protect data security.
Once the register transfer has taken place and the HPC register opened, we would normally write to everybody that has registered to welcome them to the Register. Approximately one month later the profession would go into ‘renewal’ – every profession renews its registration with us on a two-yearly cycle. Registrants would receive a renewal form and would be given three months in which to complete the form including reading and signing the declarations and returning this to us with payment. Registrants can choose to pay their fees for two years in full, or to pay via a 6 monthly direct debit. If we do not receive a completed form after two months we send a reminder; if a completed form and payment is not received by the end of the three month period, the registrant with lapse from the Register.
An organisation could potentially only send a proportion of names on their list(s); the registers that transfer is controlled by the detail included in the Section 60 Order. For example, when practitioner psychologists became regulated by us on the 1st July 2009, only those who held British Psychological Society practising certificates and who held or held in the past membership of one of the divisions relating to a relevant domain of practice transferred. This is fine detail that would need to be discussed between the Department of Health, the organisation concerned and us prior to the opening of the register. For example, as we register at the point of qualification and do not hold a student register, we would not want to transfer any data relating to students. In addition, we know that some registers differentiate between psychotherapists and counsellors, whilst others do not, and, depending on the final recommendations, we may need to enter into discussions about which parts or sections of registers transfer and to which ‘sub-section’ of the HPC register.
With regards whether someone can refuse their data to be transferred, this is something that an individual would need to take up with the organisation that holds their data (i.e. the holder of the voluntary register); this would also be something which might be covered during discussions with the Department of Health in specifying the registers that transfer in the section 60 order. Once the section 60 order comes into force, that gives the holder of the register the legal permission to transfer the register data.
4) What happens if someone whose data you hold after the transfer of a voluntary register does not re-register? Is it deleted, or held for the purposes of investigation of a protected title?
If someone transfers of the HPC register but does not renew their registration, they will no longer be registered and their name will no longer appear in the public-facing register.
In terms of the data we hold, if someone lapses from our register, their details would remain in our registration database (but no details would be publicly available). In many circumstances, someone may come off our register because they are taking a career break or are going on maternity leave but wish to re-register again in the future. Sometimes individuals also fail to renew their registration on time because of an oversight on their part and need to apply for readmission to the register so that they can begin to practise again. If someone has been previously registered with us, they have to complete an application form. If someone has previously been registered with us, we do not ask for proof of qualification but we ask instead for confirmation that they were previously registered. Subject to checks that the information we require has been received, they will be re-registered under their previous registration number – this avoids potentially creating duplicate entries in our register, ensuring the register remains as accurate as possible.
The information is not retained for the purposes of investigating protection of title offences. However, if we do receive a complaint about the potential misuse of a protected title, our first check is to ensure the person concerned isn’t already registered with us. Sometimes we receive complaints about the misuse of protected titles where the person is already registered with us, sometimes under their maiden rather than their married name or vice versa. In such circumstances we can normally advise the complainant and registrant as appropriate and close the case without the need for further investigation.
5) How do you know who their employer is? Why do you write to the employer?
When someone registers with us or renews their registration, we ask them to provide /update us with a home address and employer / practice address (if they have one). The employer / practice address is used in order to provide information on our online register which includes the approximate geographical area in which the registrant practises. For example, someone who worked in SE11 would have the location ‘London’ listed against their name in the online register. However, their full home or employer / practice address would not be publicly available. Listing a general area on the public-facing register means that a member of the public can easily identify a practitioner as this allows them to differentiate between registrants with the same or similar names.
If the voluntary register holds details on employer / practice address, this will normally be given to HPC as part of the Register transfer. However, this data will sometimes not be held on the voluntary register, or, in the case of a HPC registrant, this information may not have been provided or the registrant may not have kept their details up to date.
When someone lapses from the register, we will write to the employers details (if we have them) within a month to let them know that the individual has lapsed. If someone is not on our Register, then they are legally unable to continue using a protected title. We do not have powers to make any legal requirements of employers directly; it is an individual’s responsibility to renew their registration if they still wish to practise using a protected title.
We write to the known employer following feedback we received from employers who asked us to do this. They wanted to ensure that they met their obligations to ensure that their staff were registered when necessary. In particular, employers want to avoid problems that arise where a member of staff fails to renew their registration but does not advise their employer who is unaware until the next time they check the registration status of members of staff.
The letter we send to employers (if we have this information) advises them that a registrant has lapsed from the registrant and explains that they are legally unable to use the protected title for their profession until they have readmitted to the register.
This letter is only sent where we hold details and where someone has lapsed from the register because they have failed to renew their registration and pay the requisite fee by the renewal date. However, registrants may decide to come off our register at any time by voluntarily asking us to remove their name.
I hope the above is helpful and answers your questions; but please let me know should you have any additional questions or points of clarification.
Kind regards,
Michael Guthrie"
Thank you for your recent emails. I have responded to each your questions in turn below.
1) How many people do you think will be registerable?
Estimates of numbers of psychotherapists and counsellors in the UK do vary by between around 40,000 (the approximate total of individuals on the larger professional bodies' registers / membership) up to around 100,000.
Reaching a more precise figure at this stage is difficult as it is hard to quantify the number of practitioners who may practise outside of the existing self-regulatory systems run by professional bodies and associations. In addition, at this stage it is also difficult to quantify how many practitioners are registered currently with more than one organisation.
I am sorry that I am not able to be more helpful in relation to this question.
2) How many voluntary registers do you think will be involved? How many are above 1,000?
We anticipate at the present time that the numbers of registers we will need to consider for transfer will number around the 30 to 40 mark. However, we may be contacted by other organisations who wish their membership lists to be considered for transfer and there may of course be further registers established or consolidation of registers prior to the opening of any statutory register, which would affect the overall figure.
I know that the registers / membership of the BACP, UKCP, BPC and BABCP all total over 1,000 members / registrants. However, we will know more once we begin the process of making recommendations about which registers should transfer early in the new year.
3) How do voluntary registers get transferred?
In order to introduce regulation for the first time, a Section 60 Order under the Health Act 1999 is required. This piece of secondary legislation has to be passed in Westminster and in Holyrood before the regulation becomes law.
The Section 60 Order specifies which registers will transfer to the statutory register and may indicate any arrangements that need to be entered into between the HPC and the holder of that register. This is a result of discussion between the Department of Health, the organisation and the HPC.
In terms of logistics, we would work with the organisation holding the register to establish the data they hold and compare it to the data we require for registration (name, address, data of birth, etc). The transfer of data would then normally occur electronically with security measures such as encryption put in place to protect data security.
Once the register transfer has taken place and the HPC register opened, we would normally write to everybody that has registered to welcome them to the Register. Approximately one month later the profession would go into ‘renewal’ – every profession renews its registration with us on a two-yearly cycle. Registrants would receive a renewal form and would be given three months in which to complete the form including reading and signing the declarations and returning this to us with payment. Registrants can choose to pay their fees for two years in full, or to pay via a 6 monthly direct debit. If we do not receive a completed form after two months we send a reminder; if a completed form and payment is not received by the end of the three month period, the registrant with lapse from the Register.
An organisation could potentially only send a proportion of names on their list(s); the registers that transfer is controlled by the detail included in the Section 60 Order. For example, when practitioner psychologists became regulated by us on the 1st July 2009, only those who held British Psychological Society practising certificates and who held or held in the past membership of one of the divisions relating to a relevant domain of practice transferred. This is fine detail that would need to be discussed between the Department of Health, the organisation concerned and us prior to the opening of the register. For example, as we register at the point of qualification and do not hold a student register, we would not want to transfer any data relating to students. In addition, we know that some registers differentiate between psychotherapists and counsellors, whilst others do not, and, depending on the final recommendations, we may need to enter into discussions about which parts or sections of registers transfer and to which ‘sub-section’ of the HPC register.
With regards whether someone can refuse their data to be transferred, this is something that an individual would need to take up with the organisation that holds their data (i.e. the holder of the voluntary register); this would also be something which might be covered during discussions with the Department of Health in specifying the registers that transfer in the section 60 order. Once the section 60 order comes into force, that gives the holder of the register the legal permission to transfer the register data.
4) What happens if someone whose data you hold after the transfer of a voluntary register does not re-register? Is it deleted, or held for the purposes of investigation of a protected title?
If someone transfers of the HPC register but does not renew their registration, they will no longer be registered and their name will no longer appear in the public-facing register.
In terms of the data we hold, if someone lapses from our register, their details would remain in our registration database (but no details would be publicly available). In many circumstances, someone may come off our register because they are taking a career break or are going on maternity leave but wish to re-register again in the future. Sometimes individuals also fail to renew their registration on time because of an oversight on their part and need to apply for readmission to the register so that they can begin to practise again. If someone has been previously registered with us, they have to complete an application form. If someone has previously been registered with us, we do not ask for proof of qualification but we ask instead for confirmation that they were previously registered. Subject to checks that the information we require has been received, they will be re-registered under their previous registration number – this avoids potentially creating duplicate entries in our register, ensuring the register remains as accurate as possible.
The information is not retained for the purposes of investigating protection of title offences. However, if we do receive a complaint about the potential misuse of a protected title, our first check is to ensure the person concerned isn’t already registered with us. Sometimes we receive complaints about the misuse of protected titles where the person is already registered with us, sometimes under their maiden rather than their married name or vice versa. In such circumstances we can normally advise the complainant and registrant as appropriate and close the case without the need for further investigation.
5) How do you know who their employer is? Why do you write to the employer?
When someone registers with us or renews their registration, we ask them to provide /update us with a home address and employer / practice address (if they have one). The employer / practice address is used in order to provide information on our online register which includes the approximate geographical area in which the registrant practises. For example, someone who worked in SE11 would have the location ‘London’ listed against their name in the online register. However, their full home or employer / practice address would not be publicly available. Listing a general area on the public-facing register means that a member of the public can easily identify a practitioner as this allows them to differentiate between registrants with the same or similar names.
If the voluntary register holds details on employer / practice address, this will normally be given to HPC as part of the Register transfer. However, this data will sometimes not be held on the voluntary register, or, in the case of a HPC registrant, this information may not have been provided or the registrant may not have kept their details up to date.
When someone lapses from the register, we will write to the employers details (if we have them) within a month to let them know that the individual has lapsed. If someone is not on our Register, then they are legally unable to continue using a protected title. We do not have powers to make any legal requirements of employers directly; it is an individual’s responsibility to renew their registration if they still wish to practise using a protected title.
We write to the known employer following feedback we received from employers who asked us to do this. They wanted to ensure that they met their obligations to ensure that their staff were registered when necessary. In particular, employers want to avoid problems that arise where a member of staff fails to renew their registration but does not advise their employer who is unaware until the next time they check the registration status of members of staff.
The letter we send to employers (if we have this information) advises them that a registrant has lapsed from the registrant and explains that they are legally unable to use the protected title for their profession until they have readmitted to the register.
This letter is only sent where we hold details and where someone has lapsed from the register because they have failed to renew their registration and pay the requisite fee by the renewal date. However, registrants may decide to come off our register at any time by voluntarily asking us to remove their name.
I hope the above is helpful and answers your questions; but please let me know should you have any additional questions or points of clarification.
Kind regards,
Michael Guthrie"
UKCP officer election prompts new thinking on HPC
Reproduced below is a message from Andrew Samuels who has agreed to stand for election as Chair in the UKCP and is using this to bring information and debate alive on the impact of HPC on psychotherapy practice [the highlighting is mine].
"There's a strange and paradoxical feel to this election. Just at the moment when who we are and what we do as psychotherapists is going to be determined by the state, we hold an election in which individual judgement and choice will be decisive in UKCP for the first time. The idea that the future is in our hands is abroad – and at the same time, we are seeing how hard it is for some to truly accept that.
Everyone running for office says they wish to be judged on the issues and I am no exception. But the way this election is shaping up is very worrying indeed. We have seen a number of statements issued by the leadership of some sections that basically instruct their registrants on how to vote. The tone of some of these statements is not what I, for one, would have expected to see in public, as opposed to private discourse.
Equally worrying is the possibility of UKCP Central being manipulated by interests who are palpably opposed to what I am standing for. You should have received your voting papers by now but they have not been sent out. It has been suggested that the reason for this has been to allow for horse-trading between the two candidates from one section so that one would withdraw to avoid splitting their vote. The political tactic is fair enough, but not if it involves voting papers going out after the formally announced date showing only two candidates and not three, as if it were all just business as usual. Anyway, perhaps now really is the moment to focus on the issues.
HPC is not the only problem facing us but it is the one with the pressing time frame. In my position statement, which is included in Item 2 of the three items that follow this message, you will see that I am not trying to make the election into a referendum on HPC. We have other problems to face, both out there in arenas such as NICE and IAPT, and, after the way the election has gone, some pretty dire internal problems as well. I have had something to say about the whole range of issues, not just HPC.
The problem with my candidacy is that it does seek to reverse policy and hence it is an uphill struggle for me. Not least because, quite understandably you could say, the leadership of UKCP and of the sections are deeply implicated in and committed to the HPC policy. Hence they are bound to feel personally affronted if criticised and to take drastic action to stabilise their positions. I respectfully suggest that you, as registrants, do not necessarily share in the back stories of your leaderships, and I am asking you, in the secret ballot, to do your bit to restore UKCP to a commitment to some form of regulation that is more fitting to our values and traditions as psychotherapists.
For, as you will have realised, I am not opposed to all regulation. It has to be the right kind of regulation. That is why I am calling for a Convention on the Future of Psychotherapy and Counselling. There are alternative models for psychotherapy regulation, some of them having been tested in other countries. Yet I have been amazed to find, in discussion with architects of UKCP's regulation policy, that they have never even read the material.
Two ideas are worth noting. The first would be a 'Talking Heads Council', an improved version of the Psychological Professions Council that, only a few years ago, it was UKCP's policy to fight for. The other model is called the Practitioner Full Disclosure List; without going into detail, such a List would definitely safeguard the interests of the public and has other interesting features that might make it more appropriate for our profession.
I have been discussing our future with politicians from all three parties in both the Commons and the Lords. They are, by now, nearly all convinced by the arguments that HPC is wrong for us, though they do differ on how easy it would be to bring about a change. (No-one I have spoken to says a change is impossible or out of the question. They all say that a change will have to be towards a better model of statutory regulation.) There does seem to be a new willingness in Westminster and Whitehall to think again. If we send a clear message via our election that this is what we want, then, given the fact that the politicians will be thinking for a while about their own election, there is a window of opportunity. Nothing legislative that affects us is going to happen before the General Election.
This is what I am going to do about HPC if I am elected. First, I would try to bring the BACP and the BPC on board. Whether that succeeds or not, I will go to HPC and ask them to ask Government for the suspension of the process towards state regulation. Whether that succeeds or not, I will then call upon the Department of Health (and the Shadow health teams in the other parties) to back the call for the Convention on the Future of Psychotherapy and Counselling.
If this all fails, then I will assuredly work as hard as I can to get the best possible deal for UKCP in terms of how the HPC operates its register, and what the standards of proficiency and the criteria for approval as a training organisation turn out to be. I will make sure that we are adequately protected against those claims by BACP that are not sustainable (but support them where they seem to have serious grounds for complaint about the HPC proposals). I will do my best to protect the positions of those who do not wish to register, provided they adhere strictly to the rather stringent conditions of Principled Non-Compliance which are outlined in Item 3 that follows this message. It will not be enough just to do nothing at all.
You will see from this serious and detailed thought that is plain wrong for the HIPS Political Group to claim that I shouldn't even be in the election at all. The statement from this faction of HIPS is causing consternation and protest within their own section due to its defamatory choice of language, misrepresentation of the historical and contemporary facts, and authoritarian tone. Sadly, from the point of view of integrity in our professional life, the statement was distributed far and wide. I am sure it has been damaging to my chances despite the retraction of some of the wilder claims. In Item 2 that follows this message you will see my Response to what the HIPS Political Group sent out. It includes a rebuttal of their statement by a member of the UKCP Board of Trustees. When you read what Paul Atkinson has written, ask yourselves whether the HIPS statement is a reliable guide to how you should vote.
There is an election on and so everyone, including me, will tend to overstate their case. Nevertheless, I must say that the notion circulated by the Family, Couple, Sexual and Systemic Therapies Section that a vote for me will lead to people losing their jobs represents election scaremongering at its best (or worst)! Think about it for a moment. If HPC goes ahead in spite of Samuels, then no jobs will be lost. If there is another system put in place, then everyone will be in exactly the same boat. Again, no jobs will be lost. Opposing HPC won't lead to any losses of jobs. What all this shows is how invested everyone at the top of the professional tree (could we call them our Ruling Class?) is in maintaining control. Hence 'Stop Andrew at All Costs'.
Not everything that has been written is so awful, though, and I am grateful for the measured tone emanating from the Hypno-Psychotherapy Section. My reply to their statement, which is Item 1 following this message, enables me to explain why the Alliance came into being, and to remind everyone that over 850 UKCP registrants have signed the petition against regulation via HPC. No-one knows what the balance of opinion in the profession really is. Even BACP doesn't know and is at present conducting a sort of emergency poll on the HPC proposals. In my Response to the HIPS Political Group, I say it is 'amazing' that we don't know. I think I was pretty moderate in my choice of language. Maybe even after this election we still won't really know, but I will make good on my pledge to hold ballots on all matters to do with regulation in the future.
I am sure that, if elected, I will be tempted to 'go native', and to enjoy meeting with the powerful (and with the interesting) a little too much. I could well get inflated. But I will do my best to be conscious of this. I will certainly try to put a stop to the growing tendency for UKCP Central to develop a life and interests of its own, expressed in a ceaseless stream of authoritarian memoranda. As the Chair of a Member Organisation, I quite naturally get to read all the papers. Hence I feel able to say that our leaderships have got mixed up with the aims and objectives of the bureaucratic approach to civic life that is so prevalent in Britain today. I was first amused and then concerned to see that the latest papers from UKCP Central include documentation presented on forms and using language and notation identical to that used by HPC.
Go interpret!
Returning to the other challenges that face us, I think it is reasonably well known that mine was the first voice to go public about the outrage of IAPT getting all the resources from the government for its watered down version of CBT (apparently not particularly effective, according to their own research). I took a terrible hammering for speaking my mind and, though UKCP notables told me privately to keep on trucking because they couldn't be as direct in the meetings they were attending, they did nothing in public to help. What you can draw from this, in terms of what kind of Chair you want, is that I am likely to be more effective than most (in settings like the IAPT committees) to get the injustices and absurdities redressed. I would also seriously question what we are doing in the Savoy Partnership. I wouldn't advocate our leaving it as yet but we have lost our distinctive voice therein.
Similarly, with NICE, there seems to be this strange reluctance on the part of UKCP to really stick up for the kind of work we do. Either it is that, or we have not yet really worked out a concerted political strategy.
I will conclude on a personal note. I know I can be a difficult person, self-centred and bombastic at times. I am a funny mixture to myself of tough and fragile. Truly, I really didn't want to stand for this job, which is why I say in my position statement (in Item 2 below) that I was 'surprised' to be standing. At 60 years old and enjoying my clinical, academic and political work, and my personal life, I didn't need to do this. But I just felt so damn passionately that something has gone fantastically 'off' in our little world of psychotherapy. So, against my own needs for pleasure and a quieter life, I responded to requests to stand. I do so as an underdog, without the resources that candidates backed by powerful sections have. Could I really win when I have been targeted in the way I have been? We shall see. I am certainly not a 'man in a white suit', no Martin Bell – but I really think I have argued my case that it is time for a rethink by UKCP concerning its policies and its style of doing things.
I was going to say you could stop reading here but then I realised how patronising it would be to assume that you wouldn't be interested when, as they say, the future is in your hands. Please take the time (the election lasts all of October) to read through the material ....
Andrew
Sunday, 25 October 2009
And From Scotland - ministers and servants : democracy inaction [sic]
Below is a letter from Stuart Morgan-Ayrs who is replying to Robert Girvan, who you will see is from the Regulatory Unit of the Scottish Gov (his letter is reproduced below that of Stuart). I've put them in this reversed date order because Stuart's is the more vibrant, alive and interesting, of the two. Robert's is an important testasment to the kind of response many of us have been getting from government ministers and their servants, and it is easy to see the mark of the HPC itself in the reply (hence bringing us again to the question of QUANGOs and their independence from gov and vice versa).
Stuart replied on 24th October with the following:
Dear Robert
Many thanks for your most interesting response.
Sadly it would appear that either the Scottish Government is not staying up to date having ceded this to Westminster, or your colleagues in London are keeping you well and truly out of the loop.
The HPC regulation regarding BPS is proving a failure with a substantial proportion of psychologists refusing to register. A major reason for this is that considering the unregulated nature of the title "psychologist", practicing psychologists are objecting to paying a yearly fee, which gains them nothing, just to add a prefix onto the generic term! By dropping the prefix they do the same job, in the same way, for the same money, save the cash and do not have to sign up to this daft scheme!
If psychologists are doing this, who are mainly employed, how will self employed counsellors and psychotherapists behave? Why should I for example, with qualifications in all three disciplines pay over £70 per year to use the title "counsellor" or "psychotherapist", when I can simply and accurately use the generic term "psychologist", "therapist", "psychoanalyst", "life coach" or "complementary therapist" for free. For those of us with post graduate qualification and over 10 years of professional practice - we do not need silly titles verified by a government quango to sell our wares! It is only going to be the scared and freshly qualified therapists, and those people employed by the NHS that are going to bother registering! Senior therapists like myself will naturally remain professionally accountable and insured through our existing affiliations.
The BACP - one of the largest counselling and psychotherapy bodies, together with many more smaller bodies have rejected the HPC draft proposals. This is driven by the fact that the membership of these professional bodies neither meet the draft proposal requirements, nor agree with this move backwards for the profession. The profession have simply not been consulted, instead a stooge ridden practitioner liaison group was set up (later modified to get rid of dissenters!). For example taking the BACP: 80% roughly of their members (their figures) are not BACP "accredited" but are instead professionals in related industries who use counselling and are currently classed as counsellors, or volunteers. These people will be excluded or face abhorrent costs! Many therapists have already paid out many thousands of pounds for independent training (the usual standard until recently) for good training, which will now be disputed. My own initial training cost over £8,000 for nearly 5 years of training, which I was only accepted on to as a graduate, and which led to an NVQ Level 4 in Training and Development. Highly assessed - highly supervised - high standard - multiple schools of therapy, and soon to be completely ignored.
TWO legal challenges have already been initiated to question and prevent the legislation in it's current form.
A substantial university study and report has also just condemned the HPC proposals as flawed.
A publication of leading therapists in their fields has now been published explaining why the proposals are completely unacceptable. Typically these papers are scribed by professionals with far more credibility in their divisions and schools of thought than anyone consulted by the HPC!
As for the levels of qualification for counsellors and psychotherapists, this is again a bad joke. For years counselling has been accepted as a part of almost any therapy physical, mental or combined, and therefore counselling courses of a vocational nature have arisen, usually at levels 3-5 on the SQA / QCA. Most would not be considered acceptable by the HPC since they require specific content (still undefined) at a minimum level 5 level.
As for psychotherapy - post graduate sounds very nice - but the majority of courses are not university accredited! Therefore at a stroke the multitude of excellent courses, often vocational in nature will be consigned to scrap, because of a figure on the qualification scale pulled out of a closed discussion group! Why for example should a psychotherapist with say 20 years experience and existing diplomas have to retrain? Why should someone with for example a MSc in Psychology ALSO need a MSc in Psychotherapy? Why should a counsellor with level 3 accreditation and years of experience need to jump another 2 levels? And since most of the work is intuitive, why the silly emphasis on academic study anyway? What about persons with dyslexia and other learning restrictions either class, ethnic social or environmental? Counselling is a conversation, not a paper exercise and currently is a suitable career for them. It will not be if you need a university degree though! Why the discrimination against them and in favour of white middle class academic kids? And what about all the styles of psychotherapy and psychology and counselling that have no accredited university courses available? Are you going to criminalise providing these just because the courses have not yet been developed, or simply may never been available? I use Morita and other Eastern forms of psychology in my practice - university level courses are simply not available in these in the UK. Should therapists using these go and study an "approved" method like person centred (with half the history and development) and lose these methods for the public?
It would appear that your department is blindly following a course of action which is also being questioned in Westminster, and that is fundamentally flawed, not least because the HPC failed to adhere to the legal requirements of it's own mandate when (not) identifying whether this form of regulation was appropriate.
There now exist a raft of practical, ethical, philosophical, financial and legal reasons why the proposed HPC regulation is likely to fail or else do substantial damage to the industry.
Incidentally it is surely your responsibility to consult with the voluntary agencies of Scotland who employ counsellors and canvass their opinion? Are you aware that the effect of proposed measures will cause chaos and termination of services across Scotland the rest of the UK? Or are you planning to pay all the registration, grand-parenting, qualification and supervision fees on behalf of all the voluntary counsellors in the whole of Scotland? You might want to consider the bill per volunteer of registration, grand-parenting fee, any training required at undergraduate or post-graduate level to make the grade, and then reassessment! The figures we have seen include over £400 for grand-parenting and university fees can be easily into the thousands!
All that was ever required was an enforced requirement to be professionally registered with an adequate professional body, have full indemnity insurance and adhere to a nationally agreed code of conduct and ethics, with all names held centrally to ensure no jumping between associations in event of dismissal! The associations could easily be required to register all names within one register. Not exactly rocket science!
All the current proposals mean is that many of us are going to re-brand with a different job title rather than compromise our philosophical and ethical integrity if the HPC proposals go ahead. Since the numbers of us declaring this are in the thousands, PLUS the rejection of whole associations like the BACP - all the HPC is possibly going to achieve is causing us all to rename our job titles! What a waste of time, effort and tax-payer's money!
More information on this complete farce that you are signed up to!
http://www.psyreg.co.uk/
http://ipnosis.postle.net/
http://hpcwatchdog.blogspot.com/
http://www.allianceforcandp.org/pages/
Kind regards
Stuart
This is what he replied to:
ROBERT GIRVAN, Regulatory Unit
Scottish Government, Robert.Girvan@scotland.gsi.gov.uk
Dear Professor Morgan-Ayrs
Thank you for your e-mail of 21 September regarding the regulation of psychotherapists and counsellors. I have been asked to reply on behalf of the First Minister, Alex Salmond.
The regulation of these groups is a matter devolved in Scotland to the Scottish Parliament. However, the Scottish Government is currently committed to UK-wide regulation of the health professions, sensitive to Scotland’s needs. This is in the interests of the cross-border flow of staff and consistency in the application of standards across the four countries, as well as public understanding.
The White Paper Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century stated Government plans to introduce statutory regulation for psychotherapists and counsellors as a matter of priority, as what they do carries significant risk to patients and the public. The Health Professions Council (HPC) was the recommended regulator as it was designed to regulate new professional groups and had the most expertise in bringing new professions into statutory regulation and also in regulating a wide range of professions within a common system.
The final report of the Department of Health Extending Professional Regulation Working Group (EPRWG) was published on 16 July. This Group was set up as part of the implementation of the White Paper Trust, Assurance and Safety to take forward work on the scope of professional regulation. The Scottish representative on the Group ensured that our own Extending Professional Regulation Group fed in to the DH Group and vice-versa.
Given the risks presented by these groups, the EPRWG report supports the commitment to regulate psychotherapists and counsellors and recommends that the ongoing work to implement statutory regulation by the HPC should continue. The report can be viewed at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_102824
The HPC regulates by protection of title. Each of the professions regulated has at least one title which is protected in law. We are confident that the statutory regulation of psychotherapists and counsellors will promote protection of the public by restricting the use of protected titles to those who have demonstrated that they are fit to practise, and have the relevant skills, knowledge and aptitudes. Under statutory arrangements, the public will have the choice of whether or not to use a statutorily regulated, registered professional whose standards are explicit.
We are aware that there are a wide range of psychological and knowledge bases from which these psychological therapies have derived. As was the case with the introduction of statutory regulation for practitioner psychologists, for those practitioners who do not qualify for automatic transfer onto the HPC register the HPC will also provide for an interim assessment process known as ‘grandparenting’, which will allow applicants to register with them based on a more individualised assessment of their qualifications and experience.
All four constituent parts of the UK are still in the early stages of work on a regulatory system for psychotherapists and counsellors. As you note, the HPC sought the views of stakeholders with a call for ideas from 23 July 2008 to 24 October 2008. The responses informed the work of the HPC Psychotherapists and Counsellors Professional Liaison Group (PLG) set up to consider issues relevant to the statutory regulation of psychotherapists and counsellors.
The Group consisted of 17 members including representatives from professional bodies, education providers and service users. Their report has now been published and the HPC have completed a further three month consultation. The key issues they consulted on were the titles to be protected, the standards for safe and effective practice and the threshold level of qualification for entry to the HPC register. The outcome of the consultation will help inform the HPC’s recommendations to the Secretary of State and to Ministers in the devolved administrations on the regulation of this group. The consultation closed on 16 October and I hope that you submitted your views to it. The Scottish Government has also submitted a response to the consultation informed by key stakeholders.
There is still a considerable amount of work to be undertaken before statutory regulation can be implemented across the UK. We welcome the views of stakeholders as we move towards regulation, including during the further period of consultation that there will be on the eventual draft Order under section 60 of the Health Act 1999 which will put regulation in place for psychotherapists and counsellors across the UK.
I hope this clarifies the current position.
Yours sincerely
ROBERT GIRVAN
Stuart replied on 24th October with the following:
Dear Robert
Many thanks for your most interesting response.
Sadly it would appear that either the Scottish Government is not staying up to date having ceded this to Westminster, or your colleagues in London are keeping you well and truly out of the loop.
The HPC regulation regarding BPS is proving a failure with a substantial proportion of psychologists refusing to register. A major reason for this is that considering the unregulated nature of the title "psychologist", practicing psychologists are objecting to paying a yearly fee, which gains them nothing, just to add a prefix onto the generic term! By dropping the prefix they do the same job, in the same way, for the same money, save the cash and do not have to sign up to this daft scheme!
If psychologists are doing this, who are mainly employed, how will self employed counsellors and psychotherapists behave? Why should I for example, with qualifications in all three disciplines pay over £70 per year to use the title "counsellor" or "psychotherapist", when I can simply and accurately use the generic term "psychologist", "therapist", "psychoanalyst", "life coach" or "complementary therapist" for free. For those of us with post graduate qualification and over 10 years of professional practice - we do not need silly titles verified by a government quango to sell our wares! It is only going to be the scared and freshly qualified therapists, and those people employed by the NHS that are going to bother registering! Senior therapists like myself will naturally remain professionally accountable and insured through our existing affiliations.
The BACP - one of the largest counselling and psychotherapy bodies, together with many more smaller bodies have rejected the HPC draft proposals. This is driven by the fact that the membership of these professional bodies neither meet the draft proposal requirements, nor agree with this move backwards for the profession. The profession have simply not been consulted, instead a stooge ridden practitioner liaison group was set up (later modified to get rid of dissenters!). For example taking the BACP: 80% roughly of their members (their figures) are not BACP "accredited" but are instead professionals in related industries who use counselling and are currently classed as counsellors, or volunteers. These people will be excluded or face abhorrent costs! Many therapists have already paid out many thousands of pounds for independent training (the usual standard until recently) for good training, which will now be disputed. My own initial training cost over £8,000 for nearly 5 years of training, which I was only accepted on to as a graduate, and which led to an NVQ Level 4 in Training and Development. Highly assessed - highly supervised - high standard - multiple schools of therapy, and soon to be completely ignored.
TWO legal challenges have already been initiated to question and prevent the legislation in it's current form.
A substantial university study and report has also just condemned the HPC proposals as flawed.
A publication of leading therapists in their fields has now been published explaining why the proposals are completely unacceptable. Typically these papers are scribed by professionals with far more credibility in their divisions and schools of thought than anyone consulted by the HPC!
As for the levels of qualification for counsellors and psychotherapists, this is again a bad joke. For years counselling has been accepted as a part of almost any therapy physical, mental or combined, and therefore counselling courses of a vocational nature have arisen, usually at levels 3-5 on the SQA / QCA. Most would not be considered acceptable by the HPC since they require specific content (still undefined) at a minimum level 5 level.
As for psychotherapy - post graduate sounds very nice - but the majority of courses are not university accredited! Therefore at a stroke the multitude of excellent courses, often vocational in nature will be consigned to scrap, because of a figure on the qualification scale pulled out of a closed discussion group! Why for example should a psychotherapist with say 20 years experience and existing diplomas have to retrain? Why should someone with for example a MSc in Psychology ALSO need a MSc in Psychotherapy? Why should a counsellor with level 3 accreditation and years of experience need to jump another 2 levels? And since most of the work is intuitive, why the silly emphasis on academic study anyway? What about persons with dyslexia and other learning restrictions either class, ethnic social or environmental? Counselling is a conversation, not a paper exercise and currently is a suitable career for them. It will not be if you need a university degree though! Why the discrimination against them and in favour of white middle class academic kids? And what about all the styles of psychotherapy and psychology and counselling that have no accredited university courses available? Are you going to criminalise providing these just because the courses have not yet been developed, or simply may never been available? I use Morita and other Eastern forms of psychology in my practice - university level courses are simply not available in these in the UK. Should therapists using these go and study an "approved" method like person centred (with half the history and development) and lose these methods for the public?
It would appear that your department is blindly following a course of action which is also being questioned in Westminster, and that is fundamentally flawed, not least because the HPC failed to adhere to the legal requirements of it's own mandate when (not) identifying whether this form of regulation was appropriate.
There now exist a raft of practical, ethical, philosophical, financial and legal reasons why the proposed HPC regulation is likely to fail or else do substantial damage to the industry.
Incidentally it is surely your responsibility to consult with the voluntary agencies of Scotland who employ counsellors and canvass their opinion? Are you aware that the effect of proposed measures will cause chaos and termination of services across Scotland the rest of the UK? Or are you planning to pay all the registration, grand-parenting, qualification and supervision fees on behalf of all the voluntary counsellors in the whole of Scotland? You might want to consider the bill per volunteer of registration, grand-parenting fee, any training required at undergraduate or post-graduate level to make the grade, and then reassessment! The figures we have seen include over £400 for grand-parenting and university fees can be easily into the thousands!
All that was ever required was an enforced requirement to be professionally registered with an adequate professional body, have full indemnity insurance and adhere to a nationally agreed code of conduct and ethics, with all names held centrally to ensure no jumping between associations in event of dismissal! The associations could easily be required to register all names within one register. Not exactly rocket science!
All the current proposals mean is that many of us are going to re-brand with a different job title rather than compromise our philosophical and ethical integrity if the HPC proposals go ahead. Since the numbers of us declaring this are in the thousands, PLUS the rejection of whole associations like the BACP - all the HPC is possibly going to achieve is causing us all to rename our job titles! What a waste of time, effort and tax-payer's money!
More information on this complete farce that you are signed up to!
http://www.psyreg.co.uk/
http://ipnosis.postle.net/
http://hpcwatchdog.blogspot.com/
http://www.allianceforcandp.org/pages/
Kind regards
Stuart
This is what he replied to:
ROBERT GIRVAN, Regulatory Unit
Scottish Government, Robert.Girvan@scotland.gsi.gov.uk
Dear Professor Morgan-Ayrs
Thank you for your e-mail of 21 September regarding the regulation of psychotherapists and counsellors. I have been asked to reply on behalf of the First Minister, Alex Salmond.
The regulation of these groups is a matter devolved in Scotland to the Scottish Parliament. However, the Scottish Government is currently committed to UK-wide regulation of the health professions, sensitive to Scotland’s needs. This is in the interests of the cross-border flow of staff and consistency in the application of standards across the four countries, as well as public understanding.
The White Paper Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century stated Government plans to introduce statutory regulation for psychotherapists and counsellors as a matter of priority, as what they do carries significant risk to patients and the public. The Health Professions Council (HPC) was the recommended regulator as it was designed to regulate new professional groups and had the most expertise in bringing new professions into statutory regulation and also in regulating a wide range of professions within a common system.
The final report of the Department of Health Extending Professional Regulation Working Group (EPRWG) was published on 16 July. This Group was set up as part of the implementation of the White Paper Trust, Assurance and Safety to take forward work on the scope of professional regulation. The Scottish representative on the Group ensured that our own Extending Professional Regulation Group fed in to the DH Group and vice-versa.
Given the risks presented by these groups, the EPRWG report supports the commitment to regulate psychotherapists and counsellors and recommends that the ongoing work to implement statutory regulation by the HPC should continue. The report can be viewed at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_102824
The HPC regulates by protection of title. Each of the professions regulated has at least one title which is protected in law. We are confident that the statutory regulation of psychotherapists and counsellors will promote protection of the public by restricting the use of protected titles to those who have demonstrated that they are fit to practise, and have the relevant skills, knowledge and aptitudes. Under statutory arrangements, the public will have the choice of whether or not to use a statutorily regulated, registered professional whose standards are explicit.
We are aware that there are a wide range of psychological and knowledge bases from which these psychological therapies have derived. As was the case with the introduction of statutory regulation for practitioner psychologists, for those practitioners who do not qualify for automatic transfer onto the HPC register the HPC will also provide for an interim assessment process known as ‘grandparenting’, which will allow applicants to register with them based on a more individualised assessment of their qualifications and experience.
All four constituent parts of the UK are still in the early stages of work on a regulatory system for psychotherapists and counsellors. As you note, the HPC sought the views of stakeholders with a call for ideas from 23 July 2008 to 24 October 2008. The responses informed the work of the HPC Psychotherapists and Counsellors Professional Liaison Group (PLG) set up to consider issues relevant to the statutory regulation of psychotherapists and counsellors.
The Group consisted of 17 members including representatives from professional bodies, education providers and service users. Their report has now been published and the HPC have completed a further three month consultation. The key issues they consulted on were the titles to be protected, the standards for safe and effective practice and the threshold level of qualification for entry to the HPC register. The outcome of the consultation will help inform the HPC’s recommendations to the Secretary of State and to Ministers in the devolved administrations on the regulation of this group. The consultation closed on 16 October and I hope that you submitted your views to it. The Scottish Government has also submitted a response to the consultation informed by key stakeholders.
There is still a considerable amount of work to be undertaken before statutory regulation can be implemented across the UK. We welcome the views of stakeholders as we move towards regulation, including during the further period of consultation that there will be on the eventual draft Order under section 60 of the Health Act 1999 which will put regulation in place for psychotherapists and counsellors across the UK.
I hope this clarifies the current position.
Yours sincerely
ROBERT GIRVAN
Thursday, 22 October 2009
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.
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.
Wednesday, 21 October 2009
A note on centrism (aka centralisation, and utopian holistic planning)
As you know, my interest in the 'new style auditing' (boosted here in the UK in the 1980s, with the Thatcher/Heseltine innovations in 'new public management') is the way it feeds into a more and more centralised system, giving more and more power to the utopian holistic planner and taking it away from the local folks who not only know what's going on in detail, but who are better placed to do something about a problem in a properly measured way.
So, yesterday's news story about the way that prison inspections led local prison managers to do the unthinkable (move prisoners around in order to second guess the inspectors, and secure a good result in the audit) is shocking but comes as no surprise. The excess of power in the centralist hand produces a contortion at the local level.
What is perhaps more disappointing is the way that those holding the centralised power absolve themselves of the responsibility. Dame Anne Owers was on the BBC saying that the moved would have had no effect on the inspection. Centralist utopian planners are as easily hoodwinked by the system they enjoy, as those who are subjected to it.
To parody it: the centralist thinks that the resulting perversion of duty amongst the local managers is a confirmation of their own prejudice - these guys need tough inspections to make sure they don't step out of line. A rather stupid but effective vicious circle is set up, exactly like the one that informs the HPC: 'those local practitioners need to be watched, in order to protect the public' is soon followed by, 'ooh, look what they are doing, I told you they had to be watched'.
As long as the centralist refuses to subject him or herself to even a little bit of self reflection, the system can carry on ad infinitum, and produce more and more horrendous results. A self fulfilling prophecy, and the destruction of a once pretty decent country.
So, yesterday's news story about the way that prison inspections led local prison managers to do the unthinkable (move prisoners around in order to second guess the inspectors, and secure a good result in the audit) is shocking but comes as no surprise. The excess of power in the centralist hand produces a contortion at the local level.
What is perhaps more disappointing is the way that those holding the centralised power absolve themselves of the responsibility. Dame Anne Owers was on the BBC saying that the moved would have had no effect on the inspection. Centralist utopian planners are as easily hoodwinked by the system they enjoy, as those who are subjected to it.
To parody it: the centralist thinks that the resulting perversion of duty amongst the local managers is a confirmation of their own prejudice - these guys need tough inspections to make sure they don't step out of line. A rather stupid but effective vicious circle is set up, exactly like the one that informs the HPC: 'those local practitioners need to be watched, in order to protect the public' is soon followed by, 'ooh, look what they are doing, I told you they had to be watched'.
As long as the centralist refuses to subject him or herself to even a little bit of self reflection, the system can carry on ad infinitum, and produce more and more horrendous results. A self fulfilling prophecy, and the destruction of a once pretty decent country.
Monday, 19 October 2009
Psychotherapy Organisations Poised to Challenge Health Professions Council in the Courts
This press release was sent out from psychoanalytic organisations yesterday from The College of Psychoanalysts-UK, Association for Group and Individual Psychotherapy, Association of Independent Psychotherapists, Centre for Freudian Analysis and Research, The Guild of Psychotherapists, The Philadelphia Association
The Government’s plans to regulate counselling and psychotherapy under the Health Professions Council faces a further setback this week with the threat of legal challenge by six leading psychotherapy organisations (Association for Group and Individual Psychotherapy, Association of Independent Psychotherapists, Centre for Freudian Analysis and Research, The College of Psychoanalysts-UK, The Guild of Psychotherapists, The Philadelphia Association) and the publication of a report from Kings College London and Royal Holloway, University of London, which questions the suitability of HPC as regulator. Only a week ago the publication of 'The Maresfield Report on the Regulation of Psychotherapy in the UK' showed serious problems with the Government project and with the HPC's attempts to impose itself as regulator.
The Kings College and Royal Holloway study, 'Statutory Regulation and the Future of Professional Practice in Psychotherapy and Counselling', http://www.kcl.ac.uk/content/1/c6/06/35/90/StatutoryRegulation1.pdf, funded by the General Medical Council and the Economic and Social Research Council, warns of over-regulation failing to provide the best model of patient care. A focus on high-profile 'media spectacles' creates a regulatory climate 'obsessed with blame', leading to regulatory practices which fail both clinicians and patients. The HPC is criticised for its failure to address political forces at work in its consultation process, with certain stakeholders battling for 'position and influence'. It concludes that HPC-style regulation may well be less effective at public protection than a profession-based mandatory regulation, with an emphasis on mediation and interpersonal processes such as supervision. Current regulatory proposals fail to recognise the complexity and subtlety of the therapist-patient relationship.
These conclusions echo those of The Maresfield Report, http://www.psychoanalysis-cpuk.org/PDF/MaresfieldReport.pdf, which also highlights HPC's expensive and adversarial system of complaints, with a growing backlog of unheard complaints and a exceptionally high rate of dismissing complaints from members of the public as 'no case to answer' (more than 70% compared to 10% in therapy organisations' existing procedures). Complainants may be required under HPC to disclose medical history and hearings take place in front of a public gallery, undermining basic principles of confidentiality. The Report also finds that although there have been several European projects to introduce statutory registration of therapists, Britain is the only European country to propose regulation for the actual content of therapy sessions.
Many of the organisations which published The Maresfield Report have also threatened a legal challenge to HPC this week via the well-known London law firm Bindmans. HPC were given the brief to assess the 'regulatory needs' of the field and to explore its own suitability as a regulator, yet proceeded as if there was simply no question that the field required regulation and that they, in fact, would be the regulator. There is concern that one motivation here may be financial: HPC budgets are growing each year, and the registration fees of counsellors and therapists would be the single largest source of income the HPC would receive from one profession.
HPC's failure to make a proper evidence-based case for regulation, ask itself critical questions as required by the statutory regime and conduct proper consultation means that its actions are open to challenge in a judicial review claim. The psychotherapy organisations involved will decide whether to issue one in the next few weeks, depending on the HPC's response to Bindmans' submission. The new reports and the legal challenge will be a major embarrassment to HPC at a time when it has begun actively lobbying both Conservative and Lib-Dem policy makers, anticipating a change of government before the proposed legislation can be introduced. It will be particularly embarrassing to HPC’s CEO Marc Seale, who is trying to push through this controversial regulation while many politicians are becoming critical of the once received wisdom of the project.
Sunday, 18 October 2009
My response to the HPC Consultation on the regulation of Counselling & Psychotherapy
Submission to the HPC Consultation on the State Regulation of Counselling & Psychotherapy. Oct 2009.
Janet Low, MA PhD. Clinical Associate (CFAR), MBACP. Visiting Honorary Fellow at Manchester Metropolitan University.
Author: HPCwatchdog.blogspot.com
When Professor Richard Gombrich spoke at the Rally of the Impossible Professions (September 2008) he quoted from Karl Popper’s 1940s essay, Piecemeal Social Engineering. Since then, I have found myself dipping into this old essay and finding much of interest and use for understanding the predicament we face today. I have decided to kick off this submission with a quote from that essay, in which he considers the virtues of the piecemeal social engineer as opposed to the recklessness of the idealistic holistic planner. I hope that his words might find an echo in the soul of the person delegated to read my submission, and that some of the Popper’s wisdom and experience might help to redirect us back onto a more practical path.
“while the piecemeal engineer can attack his problem with an open mind as to the scope of the reform, the holist cannot do this; for he has decided beforehand that a complete reconstruction is possible and necessary. This fact has far-reaching consequences. It prejudices the Utopianist against certain sociological hypotheses mentioned which state limits to institutional control… For example expressing uncertainty due to the personal element, the ‘human factor’. By a rejection a priori of such hypothesis, the Utopian approach violates the principles of scientific method. On the other hand, problems connected with the uncertainty of the human factors must force the Utopianist, whether he likes it or not, to try to control the human factor by institutional means, and to extend his programme so as to embrace not only the transformation of society, according to plan, but also the transformation of man. ‘The political problem, therefore, is to organise human impulses in such a way that they will direct their energy to the right strategic points, and steer the total process of development in the desired direction."
It seems to escape the well-meaning Utopianist that this programme implies an admission of failure, even before he launches it. For it substitutes for his demand that we build a new society, fit for men and women to live in, the demand that we ‘mould’ these men and women to fit into his new society. For those who do not like living in it only admit thereby that they are not yet fit to live in it; that their ‘human impulses’ need further ‘organising’. But without the possibility of tests, any claim that a ‘scientific’ method is being employed evaporates. The holistic approach is incompatible with a truly scientific attitude.” p311 of A Pocket Popper, edited by David Miller, andpublished by Fontana in 1983
Responses to the consultation questions:
1. Do you agree that the Register should be structured to differentiate between psychotherapists and counsellors? If not, why not?
No. The HPC has not grasped the difference between counselling and psychotherapy and it would be irresponsible to blunder in and impose the distinction without an intelligent and realistic explanation as to why. There are many differences, not only between counselling and psychotherapy but amongst those that would go under each name. Without an appreciation of the reality of the work, the effect of HPC regulation will almost certainly distort and obfuscate the situation which will in turn actively not protect the public. It is possible that the men and women charged with putting the system to work in the real world may succeed in overcoming this tendency to distort, but this would be a strange thing to expect people to do, and unrealistic to expect them to do it for long.
2. Do you agree that the Register should not differentiate between different modalities? If not, why not?
Q2 Yes. The complexity of reality will be damaged and should not be contemplated by the HPC, who have no obligation to understand the reality or experience of the field.
3. Do you think that the Register should differentiate between practitioners qualified to work with children and young people and those qualified to work with adults? If yes, why? If not, why not?
No. To attempt this is to fundamentally misunderstand the nature of regulation as practiced by the HPC. The request to split the register in this way will simply result in a false segmentation in the market for training.
4. Do you agree that ‘psychotherapist’ should become a protected title? If not, why not?
No, the prospect of state, statutory, and HPC regulation on this field has already distorted it to the point where the words psychotherapy and counselling have been and continue to be detached from any meaningful subject. A mixture of entrepreneurial politics, and a failure to really address the meanings and uses of the titles has led some members of the field to fudge the labels and use them as marketing tools with an eye to possible pay differentials in a post regulation world. This is a good example of the distortion that can happen when statutory regulation looms large on the horizon. Unless and until sensible, level headed, cool and calm thinking is allowed to happen around this question, the title should not be protected. The confusion cannot foster an enlightened public, and will leave members quite vulnerable to misunderstanding. Daniel P Hogan’s work (1978) concludes that unless there is a well defined body of knowledge to define a practise, statutory regulation should be avoided.
5. Do you agree that ‘counsellor’ should become a protected title? If not, why not?
No. The generality and normality of the word is the value of the word. To bring it within the jurisdiction of the HPC or statutory power will set up all kinds of unexpected difficulties in unexpected places. It has already been noted by the HPC that changes in law will be necessary to make it possible to protect the title. This is a good example of the way labyrinths of bureaucratic structures become necessary when the centralised planner does not recognise the truth of reality. In extreme cases this can lead to the application of force, as the powerful structures try to force reality to fit, rather than admit defeat. A point made succinctly by Popper, in the quote that preceding this response.
6. Do you agree with the approach to dual registration outlined in the report? If not, why not?
No. Dual registration threatens to get out of hand (as the recent Council discussion on Sonography testifies). The power of good regulation emanates from the fact that the practice in question can be clearly defined and known. The idea of a profession is that of something a person dedicates their life to. Whereas this is true for some who engage in counselling and psychotherapy, it is also true that many do so alongside other occupations (and don’t forget, many people work voluntarily). The life experience, and the open mindedness of this is itself a valuable resource, which prevents counselling and psychotherapy from mistaking themselves for discrete and immutable objects. There is little indication that the HPC process will be able to distinguish well enough between the various practices to know whether or not someone is doing one thing or another. Arts Therapy and Counselling Psychology are good examples of this. They are currently used to justify the inclusion of psychotherapy and counselling in the HPC register, yet this argument holds within it a logical contradiction. There may also be difficulties arising from the practice of body psychotherapy and some other parts of the register. Border disputes might be another unintended consequence of the process. The beauty of the wide field of counselling and psychotherapy is that it draws from such a diversity of experience in society. The fact that almost anyone can in principle speak and listen is a reason for not regulating it via the HPC. The practice is distinct in this way, and poses special problems for HPC regulation. The true nature and extent of trouble caused by this state of affairs is not known in any useful way. For those who are particularly animated by this, may I recommend some level headed and objective research be done into the literature before a careful and sensitive inquiry be opened up in the actual time and place that presents the most concern.
NB. On several occasions during the course of the PLG I heard members of the HPC advise their new colleagues to ‘forget what happens in practice at the moment, and invent a totally new profession’ (Prof Annie Turner was the most consistent proponent of this view). This advice is wrong and puts in question the whole direction of HPC regulation for the field. A similar line was also articulated by Jonathan Bracken at the HPC Council meeting when the groups within the Psychologists were arguing for PhD entry level criteria. Bracken reminded Council members that they had decided upon the correct standards for practice and should not give in to ‘what currently happens in reality’. This is highly questionable, and throws serious doubt on the ability of the HPC to regulate any practitioners. It appears to belie an underlying cynicism which would predict perverse consequences. I shall return to this in due course.
7. How appropriate are the draft criteria for voluntary register transfers?
Inappropriate – it is the way that an organisation puts them into practise that is the most valuable criteria, and this can vary over time. The system in use by the HPC does not afford the time or skill to forge the kind of relations that are necessary to make a judgment on the quality of the various registers.
8. Do you have any comments on the outline process for identifying which registers should transfer?
The very large number of registers being considered by the HPC is cause for much concern. HPC cannot make a relationship with each register, and is therefore in a very difficult position to trust and judge. If the HPC must rely on answers from a questionnaire such as this, we should all be very worried about the quality of data entering the system.
9. What evidence might an organisation holding a voluntary register provide in order to support their submission?
Unfortunately, over the last 10 years or so, the word ‘evidence’ has been distorted to such a degree that in many contexts it has become almost meaningless (there are of course exceptions to this, but in general, unless the discursive space is carefully protected, the word tends to becomes a political weapon rather than a valuable way of transmitting information). This is, to put it mildly, a pity. However, it does furnish us with another good opportunity to observe the way that political power can twist and pervert the ordinary course of things (the phrase Evidence Based Medicine was invented as a political slogan by Archibold Cochrane back in the 70’s, it only became popular after the new Labour Government promoted it as a policy for ‘modernising’ the NHS, and for solving the BSE/CJD problem.).
In the ‘old days’, before the capture of ‘evidence’ by politics, it would be possible to think that your question included an idea of a real human being looking for a variety of information from a number of sources and weighing up reality in order to make a judgment. Here we can also draw on the parallel field of law, where evidence takes part in a complex system of investigation, prosecution, defense, cross examination, review and assessment by jury, and, finally judgment. In other words, evidence must always be weighed up in relation to the social arrangements that are made around it. In answering this question, then, I must make an assumption about the way that the ‘evidence’ will be used – ie, what is the context in which information will be turned into evidence, and what is the quality of the personnel that will interpret the information and form judgments. I think there is rather a high chance that the computerized context of the HPC will favour an automatic reading of evidence which will reduce information to little more than ticks in boxes. In other words, I strongly recommend you reflect seriously on what you are asking for here.
10. Do you agree that the grand-parenting period for psychotherapists and counsellors should be set at two years in length?
If the HPC cannot avoid becoming the regulator of this field, the grand-parenting period should surely approach infinity to allow conscientious and serious practitioners to remain safe from the threat of the distorting effects of its power until a proper solution is found. Even those who are actively seeking HPC regulation know that there are very many problems indeed to be sorted out before regulation will be functioning effectively. It is sensible to leave a very large margin in order to reduce what is likely to be inadvertent damage, and thus to increase the possibility of protecting the public. In doing this, the HPC would also gain a realistic view of the opinions of those in practise as to the quality of the regulation it proposes. At present the HPC cannot hope to gauge a measure of success as the regulation already comes with the force of law. At this year’s Annual Meeting I heard Mr Seale laugh cheerfully and say that many professionals are embarrassingly positive about being regulated by the HPC – this ‘evidence’ could be interpreted in a number of ways, not all of which would be flattering to the HPC. The presence of statutory power can easily distort the context in which information is produced. To be embarrassingly cheerful could as easily parody a highly distorted relation not unlike that between a cheerful slave and its cruel or stupid master.
11. Do you think that the standards support the recommendation to differentiate between psychotherapists and counsellors?
No.
12. Do you think the standards are set at the threshold level for safe and effective practice? If not, why not?
No. The vast majority of the standards are completely irrelevant (the generic standards), and are almost certainly going to set up a distortion in this particular field of work. This will actively not protect the public – ie, will make the public less safe. Secondly, those standards which have been written specifically for counselling and psychotherapy were cobbled together from a variety of other aborted attempts, and are only here presented as a finished item to fit in with an arbitrary time table. There has been no testing out in pratise of these standards, and no attempt has been made to think through the possible negative consequences in the various practices and modes of training that exist up and down the country.
There is something crucial to say at this point. Those who have been engaged in this process have revealed a lot of different motives and justifications for their participation. For one, it is to prevent certain specific others from practicing (a personal motive), for another it is to make sure that they have some say in whatever happens, the better to make a buffer to protect their members from the worst effects of the new system. A third says openly that these standards will have no effect whatsoever on practice, so for him they are a façade to be erected behind which ‘business can carry on as usual’. Several of those PLG members drawn from the counselling and psychotherapy field have also openly said that they would not chose the HPC as the regulator, but were participating in a process they didn’t agree with, because they had no choice. One even said she was dragged to the table, though she conceded she had been willing to be dragged but only in order to influence things from inside the system.
From those PLG members who were there from other parts of the HPC, two thought they should persuade the counsellors and psychotherapists to actually invent a brand new profession so that the HPC would be able to regulate it! Another thought that the variety and diversity in the field of counselling and psychotherapy was a ‘mess’ and intended to use HPC mechanisms ‘to tidy it up’. A third, or rather, fourth, was preoccupied with bringing professionals into fitness to practise procedures in order that the HPC triumph over it’s rival the GMC in an imaginary competition of ‘show trials’. Yet another member of the PLG held up proceedings for almost half an hour to consider how to prevent people from practising who had ‘a boy scouts badge in counselling’ thus insulting the institute of boy scouts!
The list of examples goes on. The process was not set up in such a way to ‘bring out the best’ from its constituents. The chairing of the meeting was insipid, un-inspiring, not rigorous, and became famous for a set of phrases: ‘we’ll park that for the moment’, ‘put that in the pot’, ‘we’ll come back to it later’. Each of those phrases might be put to good use in such a context, but here they signified stalling, avoiding, postponing and almost completely succeeded in preventing any serious sensible discussion from taking place at all.
This, however, was no ordinary incompetence and even seems possible to signify an underlying cynicism. From the beginning of the process the chair and other practitioner members of the HPC Council emphasized that the meeting was not one in which decisions should be made, but that it should be thought of as a place to ‘keep it vague, and make a sketch’. This somewhat extraordinary aim was made especially clear when the Chair brought the meeting to a ‘false close’ at the end of a very short first meeting, and again in the second meeting after a short and largely sneering discussion on the question of ‘conscientious objections’. She said: ‘we can be seen to have done justice to the question’ presumably because a small amount of time could be recorded in the minutes. Being seen to do something, here, sounds remarkably like ‘pretending to do something’ and in fact this latter would be a better description in this case.
This is a strong claim, and one not to be made lightly. However, the constant prevarication also meant that at the 11th hour the PLG had to resort to the extraordinary measure of asking Peter Fonagy and Mick Cooper to ‘get together over lunch’ to come up with a differential to settle the tricky question of distinguishing counselling from psychotherapy. Kathi Murphy objected strongly but was pretty much ignored as Diane Waller eagerly took up the suggestion (made by Julian Lousada). This meant that, for those of us watching from the back of the room, the complexities of the matter were being taken out of the hands of those who had knowledge of the realities of this distinction and were given to two individuals. That is, Mick Cooper was there as Professor of Counselling, and to Peter Fonagy whose place on the PLG has been obscured and left ambiguous.
It is important now to say something of this. Peter Fonagy has very many titles, but probably it is an important aspect of many of these that he is, or at least has been, a training analyst in the British Psycho-Analytical Society, now known as the BPC. Julian Lousada is openly attributed as a member of the BPC and this is further confirmed when his absence draws forth a substitute, the BPC CEO Malcolm Allen. This leaves Peter Fonagy as the ‘representative’ of Skills for Health. The Chair of the PLG therefore took advice from the BPC (Julian Lousada) to allow another member of the BPC to define psychotherapy, and overruled objections from the UKCP (UKCP rep Kathi Murphy later said she would not dispute the definition at the meeting because she knew that this would go out to public consultation). The history of psychotherapy in the UK makes this move an extremely controversial one, and exposes Diane Waller as, at best, extremely naïve.
A second reading of the same scenario is also left wide open – that the chair of the PLG delegated the defining of psychotherapy to Skills for Health. This is the official line, given the official designation of Fonagy to that organisation in all the HPC paperwork. This is an extraordinary thing to do in any case, but is made worse but the frequent plaintive cries of the HPC (Waller and Guthrie for example at the Manchester Stakeholder Event) that the SfH has no influence on the HPC.
It is not unreasonable, of course, to invite someone from one place (is Fonagy an employee of SfH?) and to make use of his wide-ranging skills while he is there, but in the interests of transparency, an effort must be made to explain the logic, reasons, rationalities of such a decision. What is clear in all this is that complex and difficult issues were rushed, squashed, collapsed and condensed, and their consequences were not given much consideration.
13. Are the draft standards applicable across modalities and applicable to work with different client groups?
No.
14. Do you think there are any standards which should be added, amended or removed? To begin, all of the generic standards should be removed. To follow, all of the specific standards are contentious, disputable and highly partial. None of them has been tested out in practice, or at least no attention has been given to any knowledge or experience of this.
15. Do you agree that the level of English language proficiency should be set at level 7.0 of the International English Language Testing System (IELTS) with no element below 6.5 or equivalent? (Standard 1b.3)
No.
16. Do you agree that the threshold educational level for entry to the Register for counsellors should be set at level 5 on the National Qualifications Framework? If not, why not?
No. The NQF is not appropriate to this field. It is the mix of people that is important, rather than creating a homogenized ‘army’ of workers. The revolution in education in the UK at present is a further problem here. This was discussed many times at the PLG without coming to any useful conclusion. Again we have the dispiriting situation where people working in the real world are having to stretch the truth extremely thin in order to make the centralist planners dream appear to come true.
17. Do you agree that the threshold educational level for entry to the Register for psychotherapists should be set at level 7 on the National Qualifications Framework? If not, why not?
No. See above.
18. Do you have any comments about the potential impact of the PLG’s recommendations and the potential impact of statutory regulation?
There is good reason to believe that HPC regulation of this field will produce - has already produced - perverse unintended consequences which will not only destroy important knowledge and experience within the field, create divisions and conflicts, and damage the experience of those who wish to consult someone in order to overcome their difficulties, but will create an illusion of public protection which indeed then constitutes a clear and imminent danger to the public.
19. Do you have any comments about the potential implications of this work on the future regulation of other groups delivering psychological therapies?
There is good reason to think there will be many negative implications of HPC regulation within the field as well as beyond it. There are good reasons to be very cautious indeed when approaching the regulation of talking and listening.
20. Do you have any further comments?.
The HPC stands to gain at least £4m a year in fees by regulating this field and is hardly disinterested. The HPC is not answerable to its constituents: it is undemocratic. The HPC has repeatedly ignored difficult questions which threaten to contradict its belief system. The HPC has allowed itself to be used as an agent of aggression against those who question it (eg by circulating the letter of Jonathan Coe after the Manchester Stakeholder Meeting in March 09, and not then circulating the responses to that letter). The HPC has shown no evidence that it engages in serious self reflection, but conducts itself on the belief that it alone knows what is best for the good of society. I recommend a rereading of Karl Popper’s interesting and pertinent essay: piecemeal social engineering. Those more up to date and are already able to take on ideas from further a-field, might wish to turn directly to the work of Michel Foucault.
Post Script
Having closely observed the proceedings of the HPC over the course of the last year, I have very little reason to believe that my work here will be given proper consideration. Since the Call for Ideas (Oct 2008) I have been repeatedly dismayed at the way the HPC and its agents have waived aside ideas and arguments that don’t coincide with their own. It is true that I have been given the opportunity to sit silently at the back of the room and watch all the proceedings, thank you for that, but I have seen much to make me doubt the wisdom of placing my trust in the organisation.
My investigations into the history and workings of this organisation have shown how the flawed logic of the HPO2001 coupled with the lack of proper debate caused by a government’s reliance on secondary legislation has produced a thoughtless apparatus in which even minor amounts of self interest and blind prejudice are easily magnified and go on, inevitably, to cause harm.
I am very concerned by the cavalier use of the political slogan ‘to protect the public’ which without due consideration amounts to little more than scaremongering and goes on to produce cynicism.
During the course of my observations I have seen a Council member punch the air in joy to hear the ‘good news’ that registrants will be subject to higher costs if they appeal decisions of the HPC. I have heard a HPC Solicitor maliciously interpret a practitioner, and by implication, all those who have worked along side him, as long time liars who have got away with sloppy practise for twenty or more years (FTP of Paul Manktelow, Registration Number: PA08359, Allegation Number: FTP01149). I have myself been subject to ridicule in front of the Annual Meeting when the CEO Marc Seale laughed at the idea that my writing on the HPC might be useful or interesting to the organisation.
None of this can be dismissed as one off chance events when seen in the context of the advertising campaign used to launch the organisation a few years ago: the picture of ‘stupid white people’ dressed up in false noses, joke moustaches and villainous eyebrows revealed the disrespectful attitude that makes up a fundamental part of this organisations culture. Incidentally, I was pleased to see the relics of this removed from the walls of HPC HQ in the summer (where they had been displayed ‘proudly’ as art works, framed and displayed on a busy corridor), but when I asked the HPC for copies of the art work from that campaign, I was stonewalled by the administrators.
I have traced the thread of this idea (‘that behind the mask lies a charlartan’) to Ian Kennedy’s 1980 Reith Lectures. The book produced as a result appeared a year later as The Unmasking of Medicine, and the cover carried the picture of a medical man who was indeed wearing a mask. The simplistic idea of Kennedy was that the mask worn by the medic was not so much done for the good of the work and the safety of all those involved, but to disguise the truly villainous nature of the man behind it. Although Kennedy said this was not his thesis, it is not difficult to read it on every page of the book. We all know that Kennedy went on to be invited by Lord Levy (on the strength of this Reith lecture work), to chair the Bristol Royal Infirmary Inquiry whose conclusions led directly to the creation of the HPC.
This is not to say that an ‘evil conniving’ man is responsible for this mess, but that a man’s prejudice has entered unchecked and has left an indelible mark. I have already mentioned the lack of proper debate surrounding the invention of the HPC (I refer to the process that allows secondary legislation to be passed that constitutes the structure of this organisation). The continual lack of proper space to think and talk through the issues is leading us towards a disaster. This is why I have chosen to bring Karl Popper into the picture.
Such a centralisation of power cannot but make fools of all of us. Anyone who gallantly enters the process and tries to make it work better, almost qualifies as a modern Sisyphus. There is, however, at least one important difference. Though Sisyphus was destined to watch his work constantly be undone, those engaged in the HPC have no such friendly enemy! The work they do is mangled, yes, but that then goes forward to become law. It then could easily then go on to be used to distort and even destroy the work of all those who are then obliged to sign up to it. Professor Micheal Power has been documenting an aspect of this process (dubbed Audit Culture) since 1994.
One important and possible good thing to come out of all of this is that those of us actively thinking about all this may learn first hand just how easy it is to turn a good thing bad. The mundane mechanisms and bland rhetoric that supports the process of HPC regulation of counselling and psychotherapy can easily pervert the good intentions or ordinary people and end up manufacturing foul deeds.
I’ll end this response by recounting something I witnessed at the final PLG meeting. One well educated and experienced professional was forced to agree to something that went against his wisdom, experience, and intellect. He said ‘ok I’ll accept it, but I may give up the will to live” (Julian Lousada on the PLG for C&P).
It does not augur well.
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