The problem with HPC regulation

Introduction
All of us who work in the field of counselling and psychotherapy, or who have an interest in it in any way, were called to respond to three documents posted on the Health Professions Council (HPC) website on 14th July 2009. The deadline for our responses was 16 October 2009, and the HPC was staggered to receive over 1000 replies. In July I wrote a report to guide some of the training organisations who were formulating their response. This coincided with an invitation to speak at the Psychology of Women Section Annual conference, where I was subsequently invited to submit a report on our HPC experiences for POWS Review. It seems useful to offer you that summer report. It offers an insight into some of the implications of HPC regulation for not only counselling and psychotherapy but for those professions, including practicing psychologist, who are already under HPC regulation.

Here follows the July 09 report …
… Few of us will know much about the background to this consultation but will probably be familiar with the catchphrase that this will ‘protect the public’. However, the lack of proper information, and the surfeit of spin provide an unsatisfactory background with which to approach it. So, it is vital that as many people and organisations in the general field of counselling and psychotherapy as possible respond to the call in order to protect the profession, and hence to protect the practice and the experience of the patient or client for many years to come.

The HPC documents appear straightforward, but are really quite difficult to understand – at times they are just plain baffling. Probably, many people who approach these documents for the first time will find them dull, confusing, and will want to walk away. Here’s an example of what awaits:
“Paragraph 2, Section 8, Education and training (p39): The HPC visits education and training providers to approve pre-registration education and training programmes against the standards of education and training. The standards of education and training are those standards necessary to ensure that someone who successfully completes that programme is able to meet the standards of proficiency for their part of the Register (the threshold standards for safe and effective practise).”
Some may hope they can take a short cut straight to the consultation document, but will find the questions assume an orientation that will need some thought to fully understand. For example, question 3 asks about structuring the register to include child psycho¬therapists as a separate title. This could easily be understood in exactly the opposite way to that supposed by the HPC and go on to produce negative unintended consequences. Most people might think: yes, you need special training to work with children. But this is not what is being asked. The relation between training and registration is not straightforward. The relation between regulation and practice is not straightforward. Nothing here is straightforward.

For the last two years I have been tracking the development of this process, and studying the sociological perspectives. This is a an important moment for the field, and everyone who cares about the tradition of psychoanalytic work needs to engage with it now, the deadline for the consultation is 16th October. There are some particular patches that might throw people off course, and I have tried to clarify these.

A potted history of the new statutory body
It is essential to grasp that this form of regulation is not the statutory regulation that much of the profession has been asking for over the years. That was a demand for power to be passed by statute to the existing professional body that would then administer business on behalf of its field of expertise. The current proposal is quite different and would more correctly be called state regulation. The difference needs to be appreciated when approaching the consultation exercise because the baseline assumptions behind the current proposals represent the complete opposite of what many will be expecting. The two approaches belong to different paradigms and don’t share common assumptions.
The Health Professions Council was created by the Health Professions Order, 2001, a piece of secondary legislation arising from the 1999 Health Act. The following year another piece of legislation (NHS Reform and Health Care Professional Act 2002) created a ‘supreme’ regulatory body, the Council for Regulating Health Professions (later renamed the Council for Health Regulatory Excellence, the CHRE), though the budget supporting it leaves it in quite a weak position. In any event, it is the HPC that receives the statutory powers delegated by Parliament to regulate the profession, not the profession itself. Here is a list of the organisations regulated by the CHRE, which shows the kind of practices regulated within this new regime.
1. General Chiropractic Council (GCC) regulates chiropractors.
2. General Dental Council (GDC) regulates dentists, dental nurses, dental technicians, dental hygienists, dental therapists, clinical dental technicians and orthodontic therapists
3. General Medical Council (GMC) regulates doctors
4. General Optical Council (GOC) regulates optometrists, dispensing opticians, student opticians and optical businesses
5. General Osteopathic Council (GOsC) regulates osteopaths
6. Health Professions Council (HPC) regulates the members of 14 health professions: arts therapists, biomedical scientists, chiropodists/podiatrists, clinical scientists, dietitians, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, practitioner psycho¬logists, prosthetists/orthotists, radiographers, speech & language therapists
7. Nursing and Midwifery Council (NMC) regulates nurses and midwives
8. Pharmaceutical Society of Northern Ireland (PSNI) regulates pharmacists in Northern Ireland
9. Royal Pharmaceutical Society of Great Britain (RPSGB) regulates pharmacists in England, Wales and Scotland
From a Centralist Government point of view, the HPC sits alongside the GMC and GDC under the CHRE. This view tends to obscure the essential difference between the HPC and all those other bodies, and creates the appearance of equality across a set of practices.

HPC, like its overseer the CHRE, has no practical knowledge, expertise or experience, and this is an innovation introduced by academic lawyer Ian Kennedy through his chairmanship of the Bristol Royal Infirmary Inquiry (see also his Reith Lectures published by George Allen & Unwin in 1981 as The Unmasking of Medicine). The CHRE and the HPC are not guided by issues of knowledge or practice, but by the very vague mission given by government: ‘to protect the public’. They are answerable not to their membership, but to the State (incarnated in our time by Her Majesty the Queen Elizabeth II) via the Privy Council (a small team of 2 Lord and 2 MPs representing the Government, and whose membership changes from time to time). The relation between the HPC and its registrants is not one of knowledge, debate or democracy but of policing and control through the creation and application of standards. The HPC constructs standards general enough to apply across all the various professions within its domain, and perhaps this is why 75 of them seem to have been written for functionaries working in the NHS (e.g. ‘recognise the need to monitor and evaluate the quality of practice and the value of contributing to the generation of data for quality assurance and improvement programmes’ 2c.1.iii)

The kind of power that sustains the HPC is quite different from that which sustains the professional bodies. In the latter, the practical work itself forms the basis for organisation: to learn from experience, to transmit knowledge grounded in practice, to create structures of supervision and control of work, to guard access to that work, and to protect those who have chosen to follow the practice from the excess vagaries of life, and thus protect the practice. In this way, society can benefit from the knowledge, expertise, and experience of the profession in question. Some problems that arise in this form of organizing include the rise of cliques who might sometimes exert undue influence on groups, or the tendency towards sloth and greed that is said to accompany success and middle age! The laws of natural justice, of ordinary rivalry and competition, a sense of duty, ethics, and pride – and of course the influx of youth – have traditionally been relied on to hold these tendencies in check.

The HPC, on the other hand, is set up on the understanding that, having no interest in or experience or knowledge of the practice, it will not succumb to the pressures of self-interest, (and by the way, it currently appoints to its Director posts no-one middle aged …). This is supposed to reduce the threat of abuse by cliques, and to make it safe for government to delegate statutory power and responsibility over professions without further need of debate in parliament. Once this assumption is accepted, the Government can satisfy the demands of many professional groups wishing to gain access to statutory power without having to consider a separate Bill and Act for each one of them. This effectively circumvents the debate traditionally deemed necessary when forging a new law.

In practice, the Department of Health must still expend the same amount of work to draft legal documents (Section 60 orders, which refer to section 60 of the 1999 Health Act) for each professional group, but the government is spared the work of debating each one in the traditional manner that would normally turn a Bill into an Act. The debating process is, then, delegated to the HPC who in their turn transform the process by managing it through its Professional Liaison Groups. There are, of course, important differences between the two kinds of debate: notably the structure and space for criticism and dissension is removed in the HPC.

As a result of this historical development, the structure and assumptions of the HPC emerge in opposition to the work of psychotherapy and counselling, and there is reason to be concerned about the effect this will have on practice post regulation. Some training organisations believe that they will be able to reform themselves as ‘buffers’ to protect practitioners from the regulator, some practitioners think they can create their own personal defenses by simply ticking the right boxes, and getting on with things as before. Few people have given detailed consideration to the realities behind these ideas, little literature appears to exist on attempts made to date in this field (but see Michael Power’s work on the Audit Explosion, Max Travers on The New Bureaucracy, Marilyn Strathern and Hari Tsoukas on the Tyranny of Transparency, and of course, Andrew Sparkes’ innovative fictional approach to academia post RAE).

To really understand the grounds on which this consultation is made, it is very important to grasp the consequences that follow from the shift in power base away from practise and towards legal standards. As these standards come back at practitioners from the independent and more powerful organisation (HPC) practitioners will find it less and less easy to take their bearings from the truth of their work. The move towards the HPC is one that gives power to the artifice, and opposes this power to that which comes from the real work. As artificial power becomes more valuable, practitioners will be more concerned that their institutions are well placed in the new system to benefit from that power. This tends to amplify conflict in the field, and polarize positions: it can easily generate a vicious cycle.

The HPC consultation lists about 50 standards applicable to both counsellors and psychotherapists, with a further 3 specific to psychotherapy, and 2 specific to counselling. These latter appear on the last pages and give the HPC something with which to differentiate their register. It is worth noticing that in this context there is no need to protect each title separately, but to ask the practitioner concerned to decide which one they are fit to use. NB: If the HPC are to successfully protect the title of Counsellor they will have to amend the law (HPO, 2001) and specify the field as one pertaining to mental-health wellbeing.

Engaging with the consultation
If you have asked for the consultation document to be sent to you in the post, you will have a thick set of papers printed back to back and held together with a very large staple. If you have downloaded it from the website, you will have three separate documents that you can manipulate a bit more easily. The actual consultation (stapled at the front of the posted pack,) asks 20 highly configured questions and attempts to keep the consultation within the frame already decided. However, question 14 asks whether there are standards which should be added, amended or removed which does allow for something more unexpected to be said.

The longest document is Michael Guthrie’s report. Michael is the Acting Director of Policy and Standards, and in spite of the grand title (and enviable youth) is not experienced in any of the areas that he now has jurisdiction over. It has been Michael’s job to turn the process of regulation into a written record, to negotiate off- stage with the solicitor on questions of legal possibilities, and to make sure the capture takes place with as little fuss as possible. He has produced a rather confusing summary of the outcome of this work, which you could look at on page 3, but that I have edited here for simplicity.

The HPC propose that:
1. The register be structured to differentiate between psychotherapists and counsellors by making each one a protected title.
2. The criteria for transferring databases from existing registers be those laid out on page 29, section 5.3 paragraph 18: i.e. prospective registers need to be clear about criteria for entry onto their register; show how its people meet those criteria; have an obligatory code of ethics tied to a complaints process; demonstrate a well functioning complaints process; CPD; commitment to supervision consistent with theory;
3. The minimum national educational level for entry into the profession for Counsellors be 5 on the National Qualifications Framework, and 7 for Psychotherapists. (This does not mean that a counsellor with level 7 qualifications can enter as a psychotherapist, it only means they have more than the minimum required to enter.) Level 7 qualifications are at a level equivalent to Master's degrees, postgraduate certificates and postgraduate diplomas.

There are 8 numbered sections to the report, but the real business is found in section 4. Michael’s job is to produce an object (Psychotherapy and Counselling) that can be taken into the HPC database, bringing onto the Register as many people in as simple a way as possible. The data will be ‘cleaned up’ later, and the entry level to the database will be ‘gradually raised’ over time. Section 4 is where discussions begin about structuring the register and protecting the titles. Once this is settled – which is essentially a job of setting the shape of the database – the rest of the sections address themselves to the practical difficulties of bringing data across. This is why the proposal is to protect the titles counsellor and psychotherapist. They have rejected splitting the register into more specific areas (e.g. modalities) because the two proposed titles capture everyone concerned. The aim of the HPC is not to protect the various divisions within the field, but to hold a database of practitioners that can pay a fee and be held to account if a complaint is lodged against them. The practitioner has a duty to train specifically for any particular practise they are interested in. The database represents a minimum entry point, and to a large extent has in mind those freshly graduated from university. In fact, it is not really necessary to protect both titles. Once the section of the register is established (Psychotherapy and Counselling) registrants could be given responsibility to choose which title to use, when. This does not actually mean that anyone can be anything, because there is a demand that people only practice at the level to which they are qualified, it is here that the fault line of the HPC is probably most clearly exposed: on the one hand there is enormous reliance on people to do the right thing (which leaves the HPC open to the charge of being irrelevant, ineffective, and wooly), and on the other hand there is a very harsh and punitive public application of law for the minority of people (less than 0.5%) who are reported on, (which leaves the HPC open to the allegation of running show trials). If you want to argue for more specific titles, e.g. modality based, then you should bear in mind that the HPC is not designed to cope with this. To specify modes of practice implies constructing specific standards that allow a lawyer to argue effectively in a fitness to pratise hearing or at a Magistrates court (where use of title may be contested).

Section 5 wonders which existing databases should be transferred from the psychotherapy and counselling organisations already in existence. Section 6 considers how to structure the entry point for individual practitioners who are not already on those lists.

Section 7 is more problematic, and refers directly to Appendix 2. Here is where things can become very confusing unless you appreciate the function of the Standards of Proficiency (SoPs) from the HPC point of view. You will notice that most of the standards begin with the words ‘understand the need to’ rather than ‘be able to’. This is because the HPC see things very much from a mass educator point of view. The University sector is a major source of registrants for the other sections of the HPC register, and the HPC spend a lot of effort laying the tracks for students to roll straight onto the register when they graduate. The parts of the register, then, are not intended to create boundaries around specific sub-practices, as this would create a protected market for the practitioners concerned. From the HPC point of view, they want to make it possible for as many different practitioners to enter onto the database in as simple a way as possible. For our part of the register, this has a direct bearing on the question of working with children. The HPC doesn’t need a separate category for those who work with children. If a separate category is made, then specific SoPs have to be created. The slogan ‘to protect the public’ gets in the way here. The HPC is essentially a database that allows complaints to be made, lawyers to be engaged, and cases to be heard. The protection of the public is not achieved through prevention, nor by enlightenment and it is here that the real tension between ideologies begins to become clear.

Section 8 presents another set of problems. Here is where the HPC begins to exert a backward pressure onto the work of the various training institutions. Even though “The HPC only approves programmes that lead directly to an individual’s eligibility to register and gain access to the relevant protected title for their profession” (paragraph 4). The trainings are only interesting to the HPC in so far as they produce the right shape of data for easy entry onto the register. However, their interest, together with the power invested in them, has a distorting effect on the structure and delivery of training. Here is another potential stumbling block for practitioners. Unless the nature of the HPC is understood, power will be handed over to a body that will not be capable of wielding it wisely.

The list that appears under the title Standards of Proficiency has never really existed until now in our practise. There have been many attempts over the years to find a way to reduce what we do to a centrally applicable list, but the attempt always fail. That the list has now been created is not due to a sudden scientific breakthrough, but because the HPC need it in order to function and set a deadline for its production. It is an artifact of the HPC and has no practical relevance to practitioners nor to training institutions. It will acquire relevance in future in order to satisfy the HPC in their future demands. It is helpful to bear this in mind when reading the list of standards. Many of them have no obvious logic behind them – they were written by a committee under a deadline, and an imperative to appear united.

The Existing, and the Proposed Standards of Proficiency
The Standards of Proficiency have been divided into three numbered groups:
1. Professional Autonomy and Accountability;
2. Identification and assessment of health and social care needs; and
3. Knowledge, understanding and skills.
Each of these sections is split further and given letters, and many have yet a third and even a fourth level of division, giving the impression of structure and order yet it is almost impossible to distill any logic from the sections and the sub-sections. It makes more sense to read them as a managerial agenda.

A second dimension also exists, and has been depicted with three different inks. This distinction refers to the kind of professional implicated in the particular standard of proficiency. The three levels are:
1. All Professionals on the HPC register,
2. The specific section in the register relating to the single profession now known as Psychotherapy & Counselling, and finally
3 either (a) Counsellors or (b) Psychotherapists.

The generic standards will be going forward for review in a separate exercise, though these standards represent a central spine of the HPC. Any comments you wish to make about them will be held until the designated review, but if you want to comment on their impact on counselling or psychotherapy practise, or their relevance for such, then you should certainly make your views known now. Remember, any review of the generic standards will be subject to input from every other profession, and this set of standards are in a sense the back bone of the HPC. All the professions in the HPC are supposed to be equivalent on a certain level - “the Government believes that all professionals undertaking the same activity should be subject to the same standards of training and practice so that those who use their services can be assured that there is no difference in quality” (Trust Assurance and Safety, White Paper 2007, para 7.17).

References
Ian Kennedy (1981) The unmasking of medicine, LondonGeorge Allen & Unwin
Michael Power (1994) The audit explosion, London Demos
Michael Power (1994) The audit society, rituals of verification, Oxford: Oxford University Press.
Andrew Sparkes’ (2007) Embodiment, academics, and the audit culture; a story seeking consideration, Qualitative Research, 7, 581
Marilyn Strathern (2000) The tyranny of transparency, The British Educational Research Journal, V26N3
Max Travers (2007) The new bureaucracy; Quality assurance and its critics, Bristol, Policy Press
Hari Tsoukas (1997) The tyranny of light; temptations and paradoxes of the information society, Futures 29(9) 827-43

Report 34, w/e 13 Nov 09. New UKCP Chair is Andrew Samuels

At 4pm on Monday 9th November the UKCP published its election results on the web. They had been expected at lunchtime.
UKCP election for Chair:
Total votes cast: 3,186
Total votes for Andrew Samuels: 2,108
Total votes for Carmen Joanne Ablack:1,074
Number of eligible voters: 6,714
Number of votes found to be invalid: 4
This was the first time that individual registrants have been eligible to vote in the elections for Chair of the UKCP and Tom Colling of the Electoral Reform Services (the independent charity commissioned to administer the voting) said: 'Turnout was very high when compared to that of other organisations. Fifty per cent is impressive”. This election marks the beginning of a new era for the organisation and is clearly a landslide with grassroots members showing their opposition to the organisational strategy to enter the HPC.
The election process, however, was plagued with bad feeling, bad behaviour and bad administration, and new Chief Executive Officer, David Pink, issued a statement on 4 November in which he said “With James [Antrican’s] support, I am asking the Board of UKCP for an independent, sober inquiry and review. I want inquiry and review, not a witch-hunt. UKCP has new lay trustees who are due to take office on 5 December; I will recommend that they are involved in the review. I think we will need to examine where things went wrong and what could have been handled better, but we need to do all this as part of a process that leads to healing and learning.”

On Saturday 7th November, at The Kings Fund, Cavendish Square, 7 UKCP Chairs, past and present, gathered to tell a story of the UKCP’s pathway toward statutory regulation. James Antrican conceived this idea as part of his final contribution as current Chair (which will be handed to Andrew Samuels on 5 December), and he used his presentation to speak of politics, controversy and power – ‘we are trying to bring psychotherapy into the world’.
The panel of speakers reflected the trajectory of history from Michael Pokorny’s optimistic days at the Rugby Conference with its dreams of independent statutory self-regulation, through to today’s ambivalent desperation about the prospect of the HPC. Michael Pokorny was clear that HPC was not right for this field, but the second speaker, Emmy van Deurzen (93-95), thought it a fantastic opportunity for the UKCP. In spite of her forthright enthusiasm she added that there was ‘a lot of rubbish’ to be cleared up before they entered, and in particular she named the ‘nonsense policy’ on criminal records, and the absurd lack of a mediation process.
Anne Casement’s presentation marked a turning point. It was during her time in the Chair (88-2001) that the Government axed all hopes of statutory self-regulation and announced its intention to impose the HPC. She resigned before the end of her term, and perhaps this would help explain why she used her UKCP talk to praise up the BPC.
Over wine and canapés at the end of the day news seeped out that the HPC had postponed the final PLG meeting, scheduled for 18 and 19 November. Both the Chair and Chief Executive of the HPC attended the afternoon meeting.
The formal notice of postponement was emailed at 1pm on Monday 9th:
• It spoke of ‘potential’ regulation yet proceeded with its intention to regulate.
• It admitted receiving an unprecedented 1000 responses to the consultation.
• It said that the Council meeting (10th December), would consider the analysis of these responses, and invited the PLG to observe.
• It anticipated “the PLG will be reconvened to undertake further work in revising the standards of proficiency”.
• Finally, it mentioned Anne Milton’s meeting from 2 November where: “participants felt that there needed to be more opportunities for discussion and debate both with HPC and within the field, about regulation.” However, any possibility of their exclusion as regulator is pre-empted by their intention “to hold a series of events next year to engage with the wider field”. These events, they say, will feed into the planned continuing work of the PLG.”


During this week some colleagues have been contacted by ‘call centre researchers’. One practitioner said “I've just had a telephone call from someone wanting to conduct a telephone interview on counselling and psychotherapy. She said she was from Skills for Health. When I asked her what it was in aid of, she told me it was something to do with the HPC but could not be more forthcoming. She said there ‘are a lot of counsellors out there who are not properly qualified'. I asked if she could send me the questions in writing but she refused, saying they were all 'on the computer' and the questionnaire could only be administered over the phone. I wondered if this was the start of the HPC/SFH's campaign to discredit anyone who opposes their regulation and/or to gather 'evidence' that there are indeed a lot of therapists 'out there' who are not 'properly qualified'.”

The BPC stage its third Savoy Conference on 26 and 27 November (£390). This series of conferences are run by The New Savoy Partnership, chaired by Jeremy Clarke, Chair of the Association for Psychoanalytic Practitioners in the NHS. Although the stated aim is to increase access for patients to a range of psychological therapies, the political distortion of these events make them seem more and more like a concerted campaign to increase the access of BPC members to jobs in the NHS and control over the training of others.

Any good intentions are buried beneath the more obvious power politics that is running roughshod over any genuine enlightened endeavour. The slogan ‘evidence based practice’ is announced in the very first paragraph of the blurb, and is swiftly followed by a statement that Andy Burnham (current Secretary of State for Health) will speak about the government’s New Horizons Framework. New Horizon takes over from the 10-year plan known as the Mental Health Framework, which saw the creation of a Mental Health Czar (Louis Appleby). It is “about driving up standards of mental health services, but also about promoting public mental health and wellbeing more widely. We want to prevent people getting depressed or mentally unwell in the first place.”
http://www.penninecare.nhs.uk/about/news/news-item/?doc=1421

BACP online Magazine Therapy Today carries letters and news relating to these concerns: The KCL Research: http://www.therapytoday.net/article/show/1427/)
The legal challenge (Bindman)
http://www.therapytoday.net/article/show/1420/
Letters: http://www.therapytoday.net/article/show/1437/
http://www.therapytoday.net/article/show/1439/
http://www.therapytoday.net/article/show/1440/

Against State Reg 2821 Against Over Reg 1711

Thanks to colleagues for their work in generating leads and information. Feedback welcome.

Anne Millton meets miserable counsellors and therapists and tries to get them talking - Nov 2nd.

The Committee Room in Westminster Hall.

“Never have I been lobbied by so many people as I have on this subject”, said Anne Milton, (Conservative MP for Guildford, and Shadow Health Minister). She had called this three-hour meeting in the Grand Committee Room, Westminster Hall to get a constructive conversation going on the future of regulation for counselling and psychotherapy. Poor old Marc Seale (HPC CEO) was forced to sit up on the stage where 60 people could take careful aim and fire their questions at him throughout the afternoon. She said it had been hard work to persuade him to come, and she only withdrew her proposal to canvass the room on the question ‘HPC or Not” when another CEO present in the room let forth a loud and heartfelt NO!

Seale was there with his Chair, Anna van der Gaag because the mail-bags of MPs have been bursting with letters complaining about the HPC. However, the only other politician in the room was Earl Freddy Howe, the conservative spokesman for health in the Lords. He didn’t speak in the proceedings.

Seale’s opening talk asked ‘in whose interest’ it was to call this conversation, which made him seem like a nincompoop, and some people got quite angry.

I was more interested in Lynne Gabriel’s talk, which came next (Lynne is Chair of the BACP). She noted that the proposed recommendations would create a very different profession from the one that currently exists. This, of course, seems outrageous to her. However, throughout the entire process of the PLG this line has been openly pushed and repeated by HPC Council members, most ardently of all by Professor Annie Turner (Occupational Therapy) who said: ‘it was only when we [OT] realised that we had to stop thinking about what actually happens in practice, and invent an entirely new profession, that we made any progress with HPC regulation.” Could it be said much more clearly than that?

Colin Walker spoke on behalf of MIND, (now at the table due to the absence of Jonathan Coe, CEO from Witness; Coe has been present throughout not only the PLG meetings for Counselling & Psychotherapy, but also for those of Psychologists). He said that there was a shocking lack of evidence of abuse by practitioners in the UK – he meant there was no reliable research in to the reality of the situation which left everyone floundering around in anecdote and hearsay.

The third speaker began by pointing out that HPC opening address had slipped rather quickly into the idea that all regulation was HPC regulation, which then enabled them to spin the argument and imply that all those who opposed HPC were opposed to all statutory regulation. “This is simply not true”, said Darian Leader (College of Psychoanalysts-UK), whose second point touched on the question of human memory. There is a long and well-documented history of argument in favour of statutory regulation, and a long and well-documented history of objection to the HPC as regulator for this field. What is absent is an explanation why people had suddenly changed their minds when the HPC had not changed at all. History has been wiped out. They had forgotten their arguments when they saw ‘the train leaving without them’ - fear had lead them to let go of their beliefs in order to preserve their political position. “This process privileges politics over the best interests of our patients”, Prof Leader concluded.

Then came questions from the floor. There was a call for a convention on the future of counselling and psychotherapy; it was noted how the HPC process had itself been instrumental in producing more and more difference in the field; Marc Seale was told to ‘keep it real’ and to take a step back. Other comments included: there’s too much use of force, authority and coercion in the process; this approach to regulation suffocates practice; I don’t recognise my practice in these standards; every organisation should be consulted; ‘we should be responsible for what our future looks like, the HPC should not tell us or impose it onto us’. There was also frustration in another direction – ‘we’ve had our chance and blown it, so now we must accept the consequences’, and one organisation said wearily, “we are happy with it, regulate us, don’t let this lot hold us back”.

Anne invited the HPC to respond but then found herself giving them advice – don’t irritate people, she said, some of this is just silly, you really have to work harder to keep people with you. And when a PLG member said he didn’t recognise what outsiders were angry with, Anne Milton had to tell him: believe me, this question is real.

(For another account of this meeting, please email info@allianceforcandp.org and request the latest newsletter).

Is the HPC Legal? STOP AND THINK! says new EU report.

Is the HPC Legal? Stop and Think! says the new report issued by The National Council for Psychotherapy.

Italian Barrister Alessandro Amicarelli was commissioned to make a full analysis of the developments of work conducted towards proposed legislation on statutory regulation of psychological therapy practitioners in the UK via the HPC. What follows is a selection of information commentary and quotes from the first half of this important document. Go to the NCP website to download a pdf for yourself.

Richard Mark of the NCP will go to Westminster Hall on Monday and present Anne Milton with a bound copy of the report, together with a full pack of appendices.

Amicarelli’s 72 page report begins by reminding us that the UK does not have a tradition of State intervention in the liberal professions, and in fact is amongst the most liberal countries in the European Union with respect to regulation. Or at least we used to be. However, after reading this report we may well wonder whether we are about to wander off this noble liberal track and turn into something a lot less familiar.

The report clarifies the most perplexing questions and comes up with some surprises:

• Is this state or statutory regulation? It is statutory, but only because the state has abdicated its responsibility.

• Is HPC independent of or accountable to the Government? It is independent, but only because the state has abdicated its responsibility.

• Is there or is there not a link between HPC, SfH, NIMHE, IAPT etc. NO! But only because the State has not thought it through.

• Why have counselling and psychotherapy not been given their own regulatory body (like doctors, dentists, pharmacists etc)? Who can say? Nobody knows.

• Why is there a different approach to regulation of doctors, dentists, midwives and other related health professions? Who can say? Does anybody care?

• What are the similarities and differences between HPC and its predecessor CPSM? The CPSM allowed professionals to choose, the HPC removes choice.

Data transfer - data capture

A distinctive feature of discourse within the HPC is 'data capture'. The organisation is structured around a data-base, and 'data capture' is indeed part of computer-geek-speak. Thanks to the essential work of Max Weber, we don't have to be naive about this expansionist, aggressive, and powerful discourse.

To mistake the HPC for an entity without its own desire might have been Ian Kennedy's folly, but the rest of us don't need to be so daft - especially with the benefit of hindsight.

The HPC stands to gain at least £4m a year in registrant fees by taking on the counsellors and psychotherapists. Sometimes they estimate that this could even be double: £8m a year. No wonder it wants to 'capture' the data. It will allow HPC to send automated invoices, and to follow those invoices with automated legal threats to chuck you in the clink for non-payment and take away your livlihood.

Some of the existing professional organisations have already taken precautions and are restructuring their own membership registers to reflect the objections of those of their members who cannot in all good conscience sign up to the HPC. People must act now to avoid their data being transferred without their permission.

If no special action is taken, then the data is automatically transferred by power of law on the date specified in any future section 60 order. If the professional decides against taking up the possibility of HPC registration their data remains on the database at the HPC 'just in case'. See the letter from Michael Guthrie to Andrew Samuels below.

Power without responsibility, oooh, it is a terrible thing.