The HPC’s latest In Focus magazine (Issue 30) contains an article preparing the ground for their five yearly review of standards. The chief concern of HPC in this project is to produce an ‘overarching’ set of standards to apply to everyone that might come under their control. These new standards will be analysed in more depth shortly. Analysing the text of this one page introductory article from In Focus reveals a number of important points – the title of this blog is one of them that rather speaks for itself. The rest are fragments from the text with a short discussion of each:
1. “There are separate standards of proficiency for each profession we regulate.” It is interesting to note that the HPC deem it necessary to include this statement rather than leaving it as read. It suggests they find it remarkable that it is still the case. The article here is concerned with a new set of standards that will be the ‘overarching’ standards which the 15 different professional standards will have to subordinate themselves to. This is a fabulous example of top down control and ignores the particulars of practice and implicitly over-rides any appeal to science or even common sense. The standards of the HPC do not flow from the actual work, they flow from a centralised committee and an amorphous public consultation. The HPC has been set up on the understanding that it can regulate without needing to know anything about the practice under its control. Each new profession captured by the HPC will make it even more difficult to attend to the diversity amongst practitioners, and cannot help but set up a pressure to reduce these distinctions to make it easier to manage. This pressure will force standards further and further away from actual practice, and closer and closer to moral or political requirements – the less interested the Regulator is in real work, the more interested it will become in its own thoughts and ideas.
2. “Your practice will develop over time, and you may find that you no longer meet all the standards of proficiency for your profession. This is not a problem.” This is from paragraph 2. Let me just quote from paragraph one: “We set standards which ‘you’ must meet, both to gain entry to the Register and to stay on the Register.” How are these two sentences to be reconciled? There is a loophole here through which different degrees of power can easily enter surreptitiously.
3. “Your service users will expect you to meet high standards of personal conduct”. This is a curious statement and seems more interested in creating a class above the rest. Why would you expect, say, an art’s therapist to have higher standards of personal conduct than yourself or, say, your postman? Also, how does the HPC know what ‘service users’ expect? There is no reference to any research which might be consulted. And of course, let us not forget that the phrase ‘service user’ is a politically correct euphemism for ‘patient’, and is incredibly unspecific (one HPC document says it refers to anyone who might know someone who comes under the care of someone on the register) a phrase which has gained currency over the last decade and which perpetuates a misunderstanding of the basic properties of language - there is no implicit moral order in the word patient which, etymologically at least, designates someone who is suffering. HPC standard setting seems to be more interested in ideology than practice. This makes it more a tool for cultural change placed in the hands of bureaucrats.
4. CPD. This requirement was brought in with Patricia Hewitt’s White Paper (Trust, Assurance, and Safety, 2007). Continuing Professional Development is a phrase that belongs to the audit culture ideology and provides the basis for commodifying knowledge and selling training courses for which certificates of attendance are now routinely produced only to be inserted into CPD files and shown to people at the HPC (and their ilk). The HPC boldly state that ‘CPD is the way you continue to learn and develop throughout your career so that you keep your skills and knowledge up to date and are able to work safely, legally, and effectively’. This, however, is a belief, not a fact. In order to substantiate the belief the government have enacted a law which has led the HPC to construct an elaborate ritual where 2.5% of registrants in a particular profession are ordered, at pain of being removed from the register, to fill in a form which proves that their CPD has done what the HPC say it does. HPC have appointed and trained Assessors (‘at least one of whom will be from the same profession as you’ proclaims the booklet), to read these forms and reject any that don’t prove the hypothesis. One physiotherapist was told that one lay-person and one physio looked at her return. She had been assured that the CPD she undertook was her business, as a professional. However, when she filled in the forms and sent them in she was surprised to receive a further communication from the HPC asking her to prove that her CPD was benefiting the service user: “The Standards could be met if the registrant can show links as to how her CPD activities within the registration period have improved her work and benefited the service user." We don’t know whether these are the comments of the lay-person or the professional, but we can find the idea written into the document that accompanies this process (downloadable, of course, from the website). It appears in between two ‘standards’ which have been created by a committee and a consultation process. One standard says ‘a registrant must seek to ensure that their CPD has contributed to the quality of their practice and service delivery’. Another says ‘a registrant must seek to ensure that their CPD benefits the service user’. The reference point has become one from business and has broken away from the rational basis of thought. This is no doubt a result of distributing ‘thinking’ over a disparate group of people none of whom can be held accountable for the consequences of their thoughts. The law of the land then pulses through this mish mash and gets imposed on real people who were otherwise busy getting on with their work. This particular physiotherapist is now very worried that the HPC might remove her from the register, and render her practise illegal, because she cannot prove that her CPD has improved the quality of her service to users! It makes her sound like a poorly functioning factory unit.
Incidentally, the administrator at the HPC is called The Customer Service Manager. Who is the customer here? Apparently the HPC think it is the registrant. However, the registrant, as we all know, is compelled through force of law to pay money to the HPC. There is no service supplied in return. They pay for the right to practice their trade (which was their right before the invention of the HPC). It would not be unreasonable to see them as a tax-payer except that this would require you to understand the HPC as a small state, and to acknowledge that in this mini-state there is taxation without representation.
And what would a lay-person have to offer to the process of assessing the CPD return of a practitioner about which they know nothing? The only thing that seems possible is that a lay person might have the kind of common sense that sometimes goes missing amongst people who know too much about something, and might therefore be helpful to ground a conversation. But the process hasn’t been set up as a conversation, and the situation has not been rescued – it is profoundly un-grounded. The lay-person, rather than one person amongst a group of professionals, is one half of the team that assesses the forms returned by the professional. If this example is typical, then apparently the comments of the assessors aren’t mediated by anyone in contact with reality, but are simply returned to the registrant with the implicit threat that they will lose their right to work. The reasoning, if such it be, behind putting lay people into this process can be traced to the lack of trust the politicians have in the professions who do the work. Remember that peurile advertising campaign that launched the HPC? It encouraged the public to doubt the veracity of the professionals' word. Pernicious stuff.
5. “We use the standards we set whenever we make a decision about [‘you’]”. This statement is nothing more than an alibi. The standards are so vague (we will come to them in due course) that they can be used in wide variety of ways (as we have seen in some of the fitness to practice cases). The HPC are using the Standards as a pseudo objective written document to justify the power they have to stop someone from working. But because the standards are so far removed from actual practice, there is nothing real to help to ground the process of judgement, which leaves the whole thing open to politics and ideology or whim. This will feel like ‘bullying’ by anyone who is unfortunate enough to be in the way. There is no reason or rationality that can be appealed to in order to ameliorate the experience of the power.
6. “As an autonomous and accountable professional, you are responsible for the decisions that you make and must be able to explain them [to us].” There is a contradiction in this that expresses an impossible wish – like that of the child who wants to know something without the having to expend the time and effort it takes to learn. A responsible professional can be expected to account for him or herself to someone who works in the field, who understands the work; an excellent teacher could explain the work to someone who actually wants to know something about it. But why should all registrants now be expected to be excellent teachers, especially when the relationship of teacher pupil is totally inverted through the misapplication of institutional power? Furthermore, by insisting that knowledge be reduced to easily digestible chunks the HPC adds to the commodification of knowledge and interrupts the natural process of transmission and acquisition that traditionally supports a community of practitioners. If that weren’t bad enough, this highly centralised system cannot possibly benefit from the knowledge it produces, anything of value is simply discarded as the process transforms into a method of judging the quality of product in an imaginary factory. The practitioner is transformed into the product.
7. “[Our] Flexible standards give you the opportunity to grow and develop within your scope of practice”. Says who? The willingness of the HPC to say whatever it wants is truly breathtaking. There are no checks and balances.
8. “[Our Flexible Standards] also allow you the opportunity to make your own decisions based on circumstances”. The wording of these statements clearly communicate that the HPC is the overlord by whose grace you, the professional, are granted permission to work. Without this permission you would not have the opportunity to make your own decisions. The HPC, remember, knows nothing about the practice, and delegates big decisions to a few hand picked professionals held in a centralised system, and (in the annual consultation jamboree) to the public at large, over whom no quality control is exercised.
9. The following statement is another great example of the way the HPC insinuate that there is a danger lurking out there that they can protect you from: “You may be placed in a situation where you are worried that something you have been asked to do, or a policy you have been asked to follow, may mean you cannot meet our standards. You may also worry that this will affect your registration. We cannot give guarantees about the outcome of every situation. However, if you make informed, reasonable, and professional judgements about your practice, in the best interests of your service users, and you can explain the decisions that you made if asked to, it is very unlikely that you would not meet our standards or that your registration would be affected.” This does nothing to reassure but is vague and suggestive, it insinuates that you can’t cope in the world without them. It is infantalising.
10. “We would welcome any comments you may have about this article of any suggestions of topics for the future”. There is no promise that thought will be given to any comments that criticise the article - the CEO (Mr Seale) has said he will 'just take on the chin' any criticisms that come his way. Judging from the way that previous comments have been dealt with by his staff it is to be expected that only comments in support of the HPC’s self image will be given any credence.
11. “Next time we will look at whistleblowing and raising concerns.” Unfortunately, nothing productive will be done with any concerns, they will simply be turned into grist for the mill in this 'ecological' disaster.
Wednesday, 11 August 2010
Tuesday, 3 August 2010
Empty speech: Mr Seale on the regulation of counsellors and psychotherapists
Last year, April 2009, an interview with Marc Seale was published on epolitix.com, the first question had two parts. It was a very clear and direct question:
Question: Why has the government decided to bring in statutory regulation for the so-called 'talking therapies'? Does the HPC believe that regulation is necessary in this field?
The response given by CEO Mr Marc Seale is vague and evasive and says almost nothing; lets take it line by line to find something more substantial to say: "The purpose of regulation is to protect members of the public"
This line has never been substantiated - there was no research of any kind - good bad or indifferent - to establish the level or nature of danger that existing practices represented. This major lack leaves us all staring at the repetition of a political statement which we are supposed to swallow whole. The lack of any kind of objective or realistic benchmarks also mean that no proper judgement will every be able to be made about improvements effected by HPC regulation. We will be left in the domain of politics. At the last meeting of the HPC Professional Liaison Group for Counselling and Psychotherapy (12 May 2010) one of the professional members said it would be necessary to offer something more tangible to critics about the way that HPC is able to give better protection to the public. He implied that very few people would be satisfied with a bland repetition of the party line. The reply came quickly from HPC Chair Dr Anna van der Gaag who said: "we offer statutory regulation". For her, the mere presence of parliamentary power is sufficient guarantee of public protection. This is simplistic twaddle at best, and there can be few who believe it, even if there are few who are prepared to say so.
Mr Seale's next sentence is: "The government has indicated that it wishes to bring in statutory regulation for a number of the 'talking therapies' including psychologists, psychotherapists and counsellors"
Yes, we can find this wish written into the White Paper (Trust Assurance and Safety, 2007), but we can find no reason or rationale written alongside it. From the context of the White Paper the common knowledge is that politicking behind the scenes by the economist Lord Layard and his allies (who came together as the 'Savoy Conference') persuaded the then government to invest £170m in some kind of 'talking cure' provision in the NHS in order to save spending on Incapacity Benefits. That Government swallowed the maths, but could not justify giving money to people who were outside its control. Hence the intention to put Counsellors and Psychotherapists under the HPC (the great irony is, however, that the people actually employed to bring about this miracle cure were all outside this established field of expertise! The only winners seem to have been those few who won the training contracts...) Until that point all the major professional groups in the field were adamant in their rejection of HPC as their regulator. With the promise of nice jobs in the NHS they capitulated. Some people might call this bribery.
Mr Seale continues: "These professions account for a large number of practitioners and there is currently no compulsory requirement for registration."
The joke is that since the 1970s psychotherapists have been traipsing along to government offices asking for statutory power to be given to them, in order regulate the field. No government has ever agreed because the field is so diverse. If one pays attention to reality and to history we can see that, yes, there are a lot of people practising in this field, and no, there is no compulsory requirement for state registration. Further, we can understand that, until now, this has never been sufficient reason to hand over statutory power. What is not said here is that almost all the practitioners in the field belong to organisations that perform a regulatory function. Most people want to belong to a community that supports their work. Mr Seale seems to imply that without some kind of external force, practitioners would skulk around in the semi shadows doing things that weren't quite right.
He goes on: "Statutory regulation means that practitioners have to be registered in order to practise, demonstrating that they meet clear standards for their conduct and competence."
There it is, without the HPC, practitioners would not meet clear standards. Now, setting standards against which to judge the competent and incompetent has been the major difficulty of the professional liaison group at the HPC. As I have mentioned many times on this blog, HPC Council Member and Occupation Therapist Annie Turner repeatedly advised the counsellors and psychotherapists on the PLG to forget what actually happens in practice, and invent new standards to fit the HPC regulatory framework. She said that her own profession struggled for a long time before it realised that the Standards used by HPC were nothing to do with the actual practise they would police. The sentence from Mr Seale, above, suggests that the public will be better protected because now there are clear standards of conduct and competence. The advice of Professor Turner is that the actual technical competence of the practitioner is something that HPC is powerless to regulate. What standards, then, is Mr Seale talking about, and how will these standards help to protect the public? What kind of danger does he imagine he will be able to combat with the kind of standards that are invented to fit into his organisational framework? I have never heard or read Mr Seale give any kind of detailed response to these important and serious questions. He certainly doesn't give it here, in this EPolitix interview:
He goes on: "It also means that effective action can be taken in the event of a complaint." This is played like a trump card. Mr Seale’s organisation is, effectively, a fitness to practise factory, the raw material is the pool of registrants that legislation puts into the HPC database. More than one third of the annual income taken from registration fees is spent on the fitness to practise department, yet the proportion of registrants it processes is less than 1% of the register. 499 cases were considered by panels of the Investigating Committee in 2009-10. The number of registrants within the domain of HPC for this period was 205,000. That is 0.24% of all registrants presented a problem. Leaving aside for the moment the kind of problem these registrants pose, we are still left with the rather dismal statistic that of those 499 cases 30% were found unproven by the final hearing. So, out of 499 possible cases from which the public, apparently, needed protection, only 352 were found to be in some way problematic. So, this organisation, with its annual income of £16m managed to ‘protect the public’ from 352 practitioners last year. These figures simply don't support the claims Mr Seale is mouthing.
He says: "We believe that independent statutory regulation of psychologists, psychotherapists and counsellors is essential in order to protect members of the public." He doesn't say why, or how. For Mr Seale, it is sufficient to repeat the party line. At a conference in London on 23 January 2010 organised by Confer (and reported on this blog), Mr Seale was invited to speak to counsellors and psychotherapists about his proposals for regulation the field. His line throughout this meeting was that, "I am only a boring bureaucrat" "I'm just a man in a grey suit" "I just carry out the orders of the government". He consistently sidestepped his responsibility (valued at £180,000 per annum plus expenses according to the figures) claiming to be nothing other than an obedient servant of politicians. Mr Seale's job, however is as Chief Executive Officer and Registrar of an organisation with an income (levied through legislation) of £16m and increasing (but what is a registrar, what does he actually do?).
In the news last week (reported in the previous blog – HPC to capture Social Workers), the new Government seems to believe that Mr Seale is independent of government. How can we square these two things? If Mr Seale is only the obedient servant of the politicians, why don't the politicians know? Without someone taking responsibility here we are left with an organisation with statutory power to levy money from practitioners to stage show trials on behalf of employers (the highest proportion of 'complaints' come from managers in the NHS).
A second question posed by EPolitix last year was:
Question: There are parties who believe that the HPC is not an appropriate regulator for the psychology, psychotherapy and counselling professions, as your current models of regulation can not successfully be applied to non-medical therapies. How would you respond to that?
Mr Seale replies: "We are confident that our model of regulation works and is sufficiently flexible to allow us to regulate these professions. We are a multi-professional regulator and we currently regulate the members of 13 different professions including physiotherapists, paramedics and art therapists."
Again, Mr Seale avoids giving a proper answer to the question and simply states his belief.
He goes on: "Our registrants work in a variety of different contexts and many of our registrants do not work within the NHS for example, working instead in areas such as the prison service, education and industry. The professions we currently regulate also practice in very different ways and to different models, not just the medical model."
Mr Seale is trying to parry the arguments made against his organisation, but he does not engage with the issues (ie the problems associated with regulating such a generalised field). It is as if none of the words have any real meaning, but are simply the ones he has been given to string together into sentences in order to get by. It is as if he knows that he doesn’t really have to bother to think about things, as he has already been given the power.
Finally: "Strong professional input is vital to our model of regulation and we ensure good professional input through the use of 'partners'. Partners are members of the professions we regulate (and lay people) who provide the expertise and advice on matters of professional practise that we need for good decision making. For example, partners may be panel members who sit on fitness to practise panels that consider complaints about registrants, others may be registration assessors or visitors to education providers."
At the Confer meeting in January the counsellors and psychotherapists that I sat with in the afternoon's discussion groups were astonished to discover that the HPC chose and appointed the people from the profession who they wanted to work with. They had assumed that the profession itself would be better placed to know the best people for the job. Of course they are, but this is not what interests the HPC. The bias produced in the field by HPC policy is very troubling and has already caused much conflict and friction. It distorts the field in ways that have nothing whatsoever to do with knowledge and practice, and everything to do with the politics and power of the HPC. What Mr Seale means when he says 'good' and 'strong', then, depends on his own idea of what is good and true, it is a political argument, not a practical one where what counts as Good and True is defined by Mr Seale. The people that the HPC chose to work with were all people who consented to HPC regulation. Those who had strong reservations about the validity of HPC-style regulation were excluded from the process. Only when the HPC process was defeated (the 'public consultation' on HPC proposals last October provoked an unprecedented 1,000 responses and prevented the HPC from moving towards legislation before the collapse of the Labour Government) did any of those Good Strong people on the PLG start talking about taking the opposition seriously. HPC still don't think that would be necessary, however. Judging from Dr van der Gaag's chairing of the last PLG meeting (12 May 2010) HPC will continue their strategy of scare tactics by collecting together cases of complaints to insinuate that the field is full of sexual predators. This tends to close the gates on rational discussion very quickly indeed, and produces a push for punitive top down control.
Mr Seale has nothing to say for himself. He doesn't understand the work he is authorised to regulate, and won't accept responsibility for that gap in his understanding. There is a vacuum. Without an active thoughtful agent willing to engage with the void, he leaves it open to opportunistic and unpredictable forces. Such forces might have little to do with goodness, truth, or with protecting the public. Really, anyone would know that to make something valuable and worthwhile you have to make an effort, even (or especially) when power is handed to you on a plate.
Question: Why has the government decided to bring in statutory regulation for the so-called 'talking therapies'? Does the HPC believe that regulation is necessary in this field?
The response given by CEO Mr Marc Seale is vague and evasive and says almost nothing; lets take it line by line to find something more substantial to say: "The purpose of regulation is to protect members of the public"
This line has never been substantiated - there was no research of any kind - good bad or indifferent - to establish the level or nature of danger that existing practices represented. This major lack leaves us all staring at the repetition of a political statement which we are supposed to swallow whole. The lack of any kind of objective or realistic benchmarks also mean that no proper judgement will every be able to be made about improvements effected by HPC regulation. We will be left in the domain of politics. At the last meeting of the HPC Professional Liaison Group for Counselling and Psychotherapy (12 May 2010) one of the professional members said it would be necessary to offer something more tangible to critics about the way that HPC is able to give better protection to the public. He implied that very few people would be satisfied with a bland repetition of the party line. The reply came quickly from HPC Chair Dr Anna van der Gaag who said: "we offer statutory regulation". For her, the mere presence of parliamentary power is sufficient guarantee of public protection. This is simplistic twaddle at best, and there can be few who believe it, even if there are few who are prepared to say so.
Mr Seale's next sentence is: "The government has indicated that it wishes to bring in statutory regulation for a number of the 'talking therapies' including psychologists, psychotherapists and counsellors"
Yes, we can find this wish written into the White Paper (Trust Assurance and Safety, 2007), but we can find no reason or rationale written alongside it. From the context of the White Paper the common knowledge is that politicking behind the scenes by the economist Lord Layard and his allies (who came together as the 'Savoy Conference') persuaded the then government to invest £170m in some kind of 'talking cure' provision in the NHS in order to save spending on Incapacity Benefits. That Government swallowed the maths, but could not justify giving money to people who were outside its control. Hence the intention to put Counsellors and Psychotherapists under the HPC (the great irony is, however, that the people actually employed to bring about this miracle cure were all outside this established field of expertise! The only winners seem to have been those few who won the training contracts...) Until that point all the major professional groups in the field were adamant in their rejection of HPC as their regulator. With the promise of nice jobs in the NHS they capitulated. Some people might call this bribery.
Mr Seale continues: "These professions account for a large number of practitioners and there is currently no compulsory requirement for registration."
The joke is that since the 1970s psychotherapists have been traipsing along to government offices asking for statutory power to be given to them, in order regulate the field. No government has ever agreed because the field is so diverse. If one pays attention to reality and to history we can see that, yes, there are a lot of people practising in this field, and no, there is no compulsory requirement for state registration. Further, we can understand that, until now, this has never been sufficient reason to hand over statutory power. What is not said here is that almost all the practitioners in the field belong to organisations that perform a regulatory function. Most people want to belong to a community that supports their work. Mr Seale seems to imply that without some kind of external force, practitioners would skulk around in the semi shadows doing things that weren't quite right.
He goes on: "Statutory regulation means that practitioners have to be registered in order to practise, demonstrating that they meet clear standards for their conduct and competence."
There it is, without the HPC, practitioners would not meet clear standards. Now, setting standards against which to judge the competent and incompetent has been the major difficulty of the professional liaison group at the HPC. As I have mentioned many times on this blog, HPC Council Member and Occupation Therapist Annie Turner repeatedly advised the counsellors and psychotherapists on the PLG to forget what actually happens in practice, and invent new standards to fit the HPC regulatory framework. She said that her own profession struggled for a long time before it realised that the Standards used by HPC were nothing to do with the actual practise they would police. The sentence from Mr Seale, above, suggests that the public will be better protected because now there are clear standards of conduct and competence. The advice of Professor Turner is that the actual technical competence of the practitioner is something that HPC is powerless to regulate. What standards, then, is Mr Seale talking about, and how will these standards help to protect the public? What kind of danger does he imagine he will be able to combat with the kind of standards that are invented to fit into his organisational framework? I have never heard or read Mr Seale give any kind of detailed response to these important and serious questions. He certainly doesn't give it here, in this EPolitix interview:
He goes on: "It also means that effective action can be taken in the event of a complaint." This is played like a trump card. Mr Seale’s organisation is, effectively, a fitness to practise factory, the raw material is the pool of registrants that legislation puts into the HPC database. More than one third of the annual income taken from registration fees is spent on the fitness to practise department, yet the proportion of registrants it processes is less than 1% of the register. 499 cases were considered by panels of the Investigating Committee in 2009-10. The number of registrants within the domain of HPC for this period was 205,000. That is 0.24% of all registrants presented a problem. Leaving aside for the moment the kind of problem these registrants pose, we are still left with the rather dismal statistic that of those 499 cases 30% were found unproven by the final hearing. So, out of 499 possible cases from which the public, apparently, needed protection, only 352 were found to be in some way problematic. So, this organisation, with its annual income of £16m managed to ‘protect the public’ from 352 practitioners last year. These figures simply don't support the claims Mr Seale is mouthing.
He says: "We believe that independent statutory regulation of psychologists, psychotherapists and counsellors is essential in order to protect members of the public." He doesn't say why, or how. For Mr Seale, it is sufficient to repeat the party line. At a conference in London on 23 January 2010 organised by Confer (and reported on this blog), Mr Seale was invited to speak to counsellors and psychotherapists about his proposals for regulation the field. His line throughout this meeting was that, "I am only a boring bureaucrat" "I'm just a man in a grey suit" "I just carry out the orders of the government". He consistently sidestepped his responsibility (valued at £180,000 per annum plus expenses according to the figures) claiming to be nothing other than an obedient servant of politicians. Mr Seale's job, however is as Chief Executive Officer and Registrar of an organisation with an income (levied through legislation) of £16m and increasing (but what is a registrar, what does he actually do?).
In the news last week (reported in the previous blog – HPC to capture Social Workers), the new Government seems to believe that Mr Seale is independent of government. How can we square these two things? If Mr Seale is only the obedient servant of the politicians, why don't the politicians know? Without someone taking responsibility here we are left with an organisation with statutory power to levy money from practitioners to stage show trials on behalf of employers (the highest proportion of 'complaints' come from managers in the NHS).
A second question posed by EPolitix last year was:
Question: There are parties who believe that the HPC is not an appropriate regulator for the psychology, psychotherapy and counselling professions, as your current models of regulation can not successfully be applied to non-medical therapies. How would you respond to that?
Mr Seale replies: "We are confident that our model of regulation works and is sufficiently flexible to allow us to regulate these professions. We are a multi-professional regulator and we currently regulate the members of 13 different professions including physiotherapists, paramedics and art therapists."
Again, Mr Seale avoids giving a proper answer to the question and simply states his belief.
He goes on: "Our registrants work in a variety of different contexts and many of our registrants do not work within the NHS for example, working instead in areas such as the prison service, education and industry. The professions we currently regulate also practice in very different ways and to different models, not just the medical model."
Mr Seale is trying to parry the arguments made against his organisation, but he does not engage with the issues (ie the problems associated with regulating such a generalised field). It is as if none of the words have any real meaning, but are simply the ones he has been given to string together into sentences in order to get by. It is as if he knows that he doesn’t really have to bother to think about things, as he has already been given the power.
Finally: "Strong professional input is vital to our model of regulation and we ensure good professional input through the use of 'partners'. Partners are members of the professions we regulate (and lay people) who provide the expertise and advice on matters of professional practise that we need for good decision making. For example, partners may be panel members who sit on fitness to practise panels that consider complaints about registrants, others may be registration assessors or visitors to education providers."
At the Confer meeting in January the counsellors and psychotherapists that I sat with in the afternoon's discussion groups were astonished to discover that the HPC chose and appointed the people from the profession who they wanted to work with. They had assumed that the profession itself would be better placed to know the best people for the job. Of course they are, but this is not what interests the HPC. The bias produced in the field by HPC policy is very troubling and has already caused much conflict and friction. It distorts the field in ways that have nothing whatsoever to do with knowledge and practice, and everything to do with the politics and power of the HPC. What Mr Seale means when he says 'good' and 'strong', then, depends on his own idea of what is good and true, it is a political argument, not a practical one where what counts as Good and True is defined by Mr Seale. The people that the HPC chose to work with were all people who consented to HPC regulation. Those who had strong reservations about the validity of HPC-style regulation were excluded from the process. Only when the HPC process was defeated (the 'public consultation' on HPC proposals last October provoked an unprecedented 1,000 responses and prevented the HPC from moving towards legislation before the collapse of the Labour Government) did any of those Good Strong people on the PLG start talking about taking the opposition seriously. HPC still don't think that would be necessary, however. Judging from Dr van der Gaag's chairing of the last PLG meeting (12 May 2010) HPC will continue their strategy of scare tactics by collecting together cases of complaints to insinuate that the field is full of sexual predators. This tends to close the gates on rational discussion very quickly indeed, and produces a push for punitive top down control.
Mr Seale has nothing to say for himself. He doesn't understand the work he is authorised to regulate, and won't accept responsibility for that gap in his understanding. There is a vacuum. Without an active thoughtful agent willing to engage with the void, he leaves it open to opportunistic and unpredictable forces. Such forces might have little to do with goodness, truth, or with protecting the public. Really, anyone would know that to make something valuable and worthwhile you have to make an effort, even (or especially) when power is handed to you on a plate.
Monday, 2 August 2010
HPC to capture social workers and change its name
On Tuesday 26 July the Department of Health announced that the General Social Care Council would go and the Social Workers currently under its regulatory authority would be passed to the HPC. The name of the HPC will be changed to reflect the new direction. Primary legislation will be required to achieve these aims.
This surprise was announced by the DH with the publication of a new document called Liberating the NHS: Report of the Arms Length Bodies Review.
Traditionally, social workers do not come under the auspice of the NHS, they come under social services which is a local authority concern. It's not clear how this move will liberate the NHS.
The DH press release says: “The General Social Care Council is an Executive Non-Departmental Public Body responsible for the regulation of social workers and social work students in England. It is anomalous as the only professional regulator answerable directly to the Secretary of State for Health.
The HPC is supposed to be answerable to the Privy Council, or perhaps to the Council for Regulatory Health Excellence. Neither of these bodies, though, seem to actually have any power over HPC. The social workers are being handed over to a body that is answerable to no-one.
“We see no compelling reason why the General Social Care Council should remain as an Executive Non-Departmental Public Body in the arm’s-length bodies sector, and we see potentially significant benefits from putting the regulation of social workers on a similar footing to the regulation of health professions. This involves the regulator being funded through registration fees charged to those registered, set at a level to cover the regulatory functions. In this way members of a regulated profession buy into their professional standards, which are set independently of government, and have an incentive to ensure these are upheld throughout the profession. …"
The potentially significant benefits will accrue to the HPC in the form of the registration fee. In effect this is a tax on the social workers. The fee paid to their own professional body is usually justified in terms of benefits accruing. Aside from the right to work, it is not clear what benefits the HPC offer in return for the fee. There are no voting mechanisms by which professionals who pay the registration fee are able to have any say whatsoever over how that money is spent. Income from fees next year is budgetted at £17m. The single most important item on the list of calls on this money is the fitness to practise department, who are due to spend £7m next year (next highest spenders are communications, IT and registration admin, each around £1m-£1.5m). The FTP department reported that 30% of its cases this year fell as not proven at hearing. All cases account for less than 1% of the total number of people registered. The production of standards by which to regulate the practice is, unfortunately, a daydream. During my observations of the Professional Liaison Group for Counselling and Psychotherapy, I heard Professor Annie Turner say more than once that the only way any profession could come up with standards suitable for the HPC was to forget what happens in practice, and invent something to fit the regime. This, sadly, does not bode well for the future of social workers, let alone the people who depend on them.
“The abolition of the General Social Care Council, the transfer of functions in relation to the regulation of the social worker workforce and related changes will require primary legislation. The timing of these changes is dependent on discussion with the Health Professions Council and the General Social Care Council to ensure an orderly transition.” Department of Health Liberating the NHS: Report of the Arms Length Bodies Review.
http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_117844
This news came out of the blue for The British Association of Social Workers. Thinking fast they announced that the new entity must strongly recognise social work in its title and its focus. Ruth Cartwright (joint manager of BASW) said the new body could be called the ‘Health and Care Profession Commission’, while the BASW Chief Exec (Hilton Dawson) thought “the Health Professions and Social Work Council” would be better. There is, of course, much concern that this sudden announcement by the DH comes without any consultation with Social Workers. Who did they consult with? Presumably the President and CEO of the HPC, whose programme of expansion is well known to anyone who cares to read the reports and listen to the meetings.
The GSCC was created in October 2001, one month before the Health Professions Order 2001 was put before the Houses of Parliament for debate. Last year the CHRE (created in 2002 by the NHS Reform and Health Care Professional Act 2002) was commissioned to review the GSCC after the senior management team collapsed. The inquisition found a huge backlog of fitness to practise hearings, and concluded that more robust paperwork systems were needed in order to deliver public protection. The Guardian reported (21 July 2009) that the Chief Exec of the GSCC had been suspended and sent home. The GSCC had been struggling to cope with the growing number of referrals since the Baby P case.
This sudden announcement in favour of HPC seems to be linked less to current government thinking than to the trajectory set up by the last Government, who published a White Paper just a few weeks before calling the General Election - ‘Building the National Care Service’ which had already nominated HPC to help push this through. The HPC had welcomed that white paper and the Government’s approach to piloting the licensing of social care workers and healthcare support workers. HPC PR said of that initiative:
“We look forward in due course to working with other stakeholders on the licensing model of regulation. We are committed to widening regulation to maximise public protection whilst not placing disproportionate burdens on the workforce.
“We believe a licensing model can achieve this balance for support workers, and we look forward to the opportunity to pilot the scheme.”
While it is not clear how Social Workers, Psychotherapists and Care Workers relate to each other as subjects for HPC regulation (let alone how they relate to paramedics, physiotherapists, and biomedical scientists), it is clear that the HPC is keen to pursue its expansion as planned, and to reduce the differences amongst practitioners to maximise economies of scale (see eIpnosis for a further analysis of this move). The new government has apparently been convinced by the argument, although this cannot be without problems within its ranks.
To understand the current news in relation to the ideas stated and published in the run up to the election, have a look at the Conservative Party’s ‘Blue Blog’ November 2009, where John Penrose (currently conservative MP for Weston-super-Mare, ex Bank Trading FloorRisk Manager, management consultant, and Commercial Director of an Academic Books Division) wrote “…As anyone who reads this blog frequently will know, I’ve been working on policies to get rid of red tape, bureaucracy and quangos. After a fair amount of hard work with the big brains in the Conservative Party, I’ve now consolidated these into a comprehensive series of reforms under the rather unsnappy title of ‘Regulation in the Post-Bureaucratic Age’, which we launched in October at the Conservative Party’s conference in Manchester."
It might be more than interesting to notice the trouble this accomplished man had in coming up with a snappy title for his work. He is probably trying to force too much into too tiny a space. This can't be comfortably for a risk manager.
“... The reforms are designed to cut at the very heart of the Government’s regulation culture and free British businesses from the regulatory millstone around their necks. We’re aiming to improve the quality and effectiveness of new regulations, and to start a culture change in Westminster and Whitehall so we can sweep away Labour’s ‘regulation for regulation’s sake’ attitude and replacing it with a less burdensome and intrusive approach."
It is noticeable and questionable that he is focussing on business rather than seeing the problem in terms of anyone who is trying to do a job of work.
“And about time too. Regulation has been snowballing out of control. It now costs businesses an extra £76 billion to keep the Government’s bureaucrats happy. That’s why it’s vital that we get this policy right. If these new listening events are anything like the one we held earlier this year, then I should have a lot to think about afterwards. I hope that everyone who attends will feel we’ve struck the spark that lights the bonfire of red tape.”
The logic that leads him to say that businesses should be allowed to save money must surely be the same logic that assumes that businesses would be better off wisely investing their money, and paying attention to their trade. But this is precisely the same logic that could be applied to anyone plying any kind of trade, even a poet. Penrose, however, does realise the pernicious way that the regulatory ideology eats away at social responsibility and has found its way into many different kinds of practice: the executive summary of the post regulation report states:
“Since 1997, the Labour Government has introduced an unprecedented number of new regulations, which have undermined social responsibility and reduced the UK’s economic competitiveness. The exponential increase in regulation has not only hit businesses (particularly small businesses), but it has also increased the bureaucratic burden on individuals, charities, public bodies and social enterprises. This has hindered innovation and social action and has also led to a rapid increase in government spending on administration and inspection regimes. Unfortunately, as we have seen with the failed system of tripartite financial regulation, Labour’s bureaucratic approach has not only impacted negatively on businesses, social enterprises, charities and public bodies; it has also been largely ineffective."
This is an important point. By asking people to pay money and attention to the regulatory ritual, not only does it stop people doing valuable things with their time and money, but it actually eats away at the normal checks and balances that people have built up in their work and which allow them to govern themselves and those around them in a more ordinary, and effective way. The regulatory ideology has nothing to ground itself with, but can only expand, spread fear, and rush on in the hope that no-one has time to ask questions.
“A different way is possible. We need to sweep away Labour's ineffective system of bureaucracy and replace it with a post-bureaucratic approach to regulation that makes use of new technologies and insights from social psychology and behavioural economics to achieve our policy goals in a less burdensome and intrusive way."
It is here that the rhetoric lets Penrose down so badly. Is it post-bureaucratic regulation he wants, or post regulatory bureaucracy. What do these words actually mean?
“Achieving this innovative and post-bureaucratic approach to regulation across government will not happen overnight. It will require a fundamental culture shift amongst policymakers in Whitehall and beyond, which will only be made possible through significant structural reforms."
Probably it is more important that people begin to really think about words and what they mean when they speak, than it is to make any innovative, post-wotnot, culture change, fundamental or otherwise.
“These structural reforms fall into two major categories. First, institutional changes that will curb the volume of new regulations, and remove existing regulations that are shown to be ineffective or overly burdensome. Second, policy changes to improve the quality and effectiveness of any new regulations, and ensure that they are genuinely post-bureaucratic and reflect the latest insights from academic research."
How can anything show itself to be genuinely post-bureaucratic unless we know what the phrase means? Without some genuine post-bullshit talking, we are going to lose some truly valuable knowledge, practices, and, probably, some absolutely essential qualities like trust, truth, and justice.
So, let's stick with the particular against this background of generalities - why has the Government suddenly decided that the Health Professions Council is a good candidate to regulate the Social Workers? It didn’t ask the social workers, so who did it ask? In the absence of any information, it seems quite likely that this sudden announcement is a result of politicking behind the scenes by the HPC who need to secure increased income to cover its expanding inefficiencies. The lack of any rationale for swapping the social workers into the Health Professions Council is very worrying. If it is possible to change the Health Professions Council into the Social Work and Health Professions Council just like that, then it looks like the HPC is the puppet of ... politicans, who themselves seem to be the puppet of ... the HPC. Is anyone taking real responsibility here? Does anyone understand what's going on?
There appears to be no idea behind the move, and no idea to behind the HPC. It might be time to turn to an article recently published in the New Statesmen by a former diplomat, and Conservative MP for Buckingham 1983-97, George Walden. The article is a bold analysis of the character, or lack of it, of the prime minister. “Nowhere Man”, is published online at the New Statesman on 28 June 2010
This surprise was announced by the DH with the publication of a new document called Liberating the NHS: Report of the Arms Length Bodies Review.
Traditionally, social workers do not come under the auspice of the NHS, they come under social services which is a local authority concern. It's not clear how this move will liberate the NHS.
The DH press release says: “The General Social Care Council is an Executive Non-Departmental Public Body responsible for the regulation of social workers and social work students in England. It is anomalous as the only professional regulator answerable directly to the Secretary of State for Health.
The HPC is supposed to be answerable to the Privy Council, or perhaps to the Council for Regulatory Health Excellence. Neither of these bodies, though, seem to actually have any power over HPC. The social workers are being handed over to a body that is answerable to no-one.
“We see no compelling reason why the General Social Care Council should remain as an Executive Non-Departmental Public Body in the arm’s-length bodies sector, and we see potentially significant benefits from putting the regulation of social workers on a similar footing to the regulation of health professions. This involves the regulator being funded through registration fees charged to those registered, set at a level to cover the regulatory functions. In this way members of a regulated profession buy into their professional standards, which are set independently of government, and have an incentive to ensure these are upheld throughout the profession. …"
The potentially significant benefits will accrue to the HPC in the form of the registration fee. In effect this is a tax on the social workers. The fee paid to their own professional body is usually justified in terms of benefits accruing. Aside from the right to work, it is not clear what benefits the HPC offer in return for the fee. There are no voting mechanisms by which professionals who pay the registration fee are able to have any say whatsoever over how that money is spent. Income from fees next year is budgetted at £17m. The single most important item on the list of calls on this money is the fitness to practise department, who are due to spend £7m next year (next highest spenders are communications, IT and registration admin, each around £1m-£1.5m). The FTP department reported that 30% of its cases this year fell as not proven at hearing. All cases account for less than 1% of the total number of people registered. The production of standards by which to regulate the practice is, unfortunately, a daydream. During my observations of the Professional Liaison Group for Counselling and Psychotherapy, I heard Professor Annie Turner say more than once that the only way any profession could come up with standards suitable for the HPC was to forget what happens in practice, and invent something to fit the regime. This, sadly, does not bode well for the future of social workers, let alone the people who depend on them.
“The abolition of the General Social Care Council, the transfer of functions in relation to the regulation of the social worker workforce and related changes will require primary legislation. The timing of these changes is dependent on discussion with the Health Professions Council and the General Social Care Council to ensure an orderly transition.” Department of Health Liberating the NHS: Report of the Arms Length Bodies Review.
http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_117844
This news came out of the blue for The British Association of Social Workers. Thinking fast they announced that the new entity must strongly recognise social work in its title and its focus. Ruth Cartwright (joint manager of BASW) said the new body could be called the ‘Health and Care Profession Commission’, while the BASW Chief Exec (Hilton Dawson) thought “the Health Professions and Social Work Council” would be better. There is, of course, much concern that this sudden announcement by the DH comes without any consultation with Social Workers. Who did they consult with? Presumably the President and CEO of the HPC, whose programme of expansion is well known to anyone who cares to read the reports and listen to the meetings.
The GSCC was created in October 2001, one month before the Health Professions Order 2001 was put before the Houses of Parliament for debate. Last year the CHRE (created in 2002 by the NHS Reform and Health Care Professional Act 2002) was commissioned to review the GSCC after the senior management team collapsed. The inquisition found a huge backlog of fitness to practise hearings, and concluded that more robust paperwork systems were needed in order to deliver public protection. The Guardian reported (21 July 2009) that the Chief Exec of the GSCC had been suspended and sent home. The GSCC had been struggling to cope with the growing number of referrals since the Baby P case.
This sudden announcement in favour of HPC seems to be linked less to current government thinking than to the trajectory set up by the last Government, who published a White Paper just a few weeks before calling the General Election - ‘Building the National Care Service’ which had already nominated HPC to help push this through. The HPC had welcomed that white paper and the Government’s approach to piloting the licensing of social care workers and healthcare support workers. HPC PR said of that initiative:
“We look forward in due course to working with other stakeholders on the licensing model of regulation. We are committed to widening regulation to maximise public protection whilst not placing disproportionate burdens on the workforce.
“We believe a licensing model can achieve this balance for support workers, and we look forward to the opportunity to pilot the scheme.”
While it is not clear how Social Workers, Psychotherapists and Care Workers relate to each other as subjects for HPC regulation (let alone how they relate to paramedics, physiotherapists, and biomedical scientists), it is clear that the HPC is keen to pursue its expansion as planned, and to reduce the differences amongst practitioners to maximise economies of scale (see eIpnosis for a further analysis of this move). The new government has apparently been convinced by the argument, although this cannot be without problems within its ranks.
To understand the current news in relation to the ideas stated and published in the run up to the election, have a look at the Conservative Party’s ‘Blue Blog’ November 2009, where John Penrose (currently conservative MP for Weston-super-Mare, ex Bank Trading FloorRisk Manager, management consultant, and Commercial Director of an Academic Books Division) wrote “…As anyone who reads this blog frequently will know, I’ve been working on policies to get rid of red tape, bureaucracy and quangos. After a fair amount of hard work with the big brains in the Conservative Party, I’ve now consolidated these into a comprehensive series of reforms under the rather unsnappy title of ‘Regulation in the Post-Bureaucratic Age’, which we launched in October at the Conservative Party’s conference in Manchester."
It might be more than interesting to notice the trouble this accomplished man had in coming up with a snappy title for his work. He is probably trying to force too much into too tiny a space. This can't be comfortably for a risk manager.
“... The reforms are designed to cut at the very heart of the Government’s regulation culture and free British businesses from the regulatory millstone around their necks. We’re aiming to improve the quality and effectiveness of new regulations, and to start a culture change in Westminster and Whitehall so we can sweep away Labour’s ‘regulation for regulation’s sake’ attitude and replacing it with a less burdensome and intrusive approach."
It is noticeable and questionable that he is focussing on business rather than seeing the problem in terms of anyone who is trying to do a job of work.
“And about time too. Regulation has been snowballing out of control. It now costs businesses an extra £76 billion to keep the Government’s bureaucrats happy. That’s why it’s vital that we get this policy right. If these new listening events are anything like the one we held earlier this year, then I should have a lot to think about afterwards. I hope that everyone who attends will feel we’ve struck the spark that lights the bonfire of red tape.”
The logic that leads him to say that businesses should be allowed to save money must surely be the same logic that assumes that businesses would be better off wisely investing their money, and paying attention to their trade. But this is precisely the same logic that could be applied to anyone plying any kind of trade, even a poet. Penrose, however, does realise the pernicious way that the regulatory ideology eats away at social responsibility and has found its way into many different kinds of practice: the executive summary of the post regulation report states:
“Since 1997, the Labour Government has introduced an unprecedented number of new regulations, which have undermined social responsibility and reduced the UK’s economic competitiveness. The exponential increase in regulation has not only hit businesses (particularly small businesses), but it has also increased the bureaucratic burden on individuals, charities, public bodies and social enterprises. This has hindered innovation and social action and has also led to a rapid increase in government spending on administration and inspection regimes. Unfortunately, as we have seen with the failed system of tripartite financial regulation, Labour’s bureaucratic approach has not only impacted negatively on businesses, social enterprises, charities and public bodies; it has also been largely ineffective."
This is an important point. By asking people to pay money and attention to the regulatory ritual, not only does it stop people doing valuable things with their time and money, but it actually eats away at the normal checks and balances that people have built up in their work and which allow them to govern themselves and those around them in a more ordinary, and effective way. The regulatory ideology has nothing to ground itself with, but can only expand, spread fear, and rush on in the hope that no-one has time to ask questions.
“A different way is possible. We need to sweep away Labour's ineffective system of bureaucracy and replace it with a post-bureaucratic approach to regulation that makes use of new technologies and insights from social psychology and behavioural economics to achieve our policy goals in a less burdensome and intrusive way."
It is here that the rhetoric lets Penrose down so badly. Is it post-bureaucratic regulation he wants, or post regulatory bureaucracy. What do these words actually mean?
“Achieving this innovative and post-bureaucratic approach to regulation across government will not happen overnight. It will require a fundamental culture shift amongst policymakers in Whitehall and beyond, which will only be made possible through significant structural reforms."
Probably it is more important that people begin to really think about words and what they mean when they speak, than it is to make any innovative, post-wotnot, culture change, fundamental or otherwise.
“These structural reforms fall into two major categories. First, institutional changes that will curb the volume of new regulations, and remove existing regulations that are shown to be ineffective or overly burdensome. Second, policy changes to improve the quality and effectiveness of any new regulations, and ensure that they are genuinely post-bureaucratic and reflect the latest insights from academic research."
How can anything show itself to be genuinely post-bureaucratic unless we know what the phrase means? Without some genuine post-bullshit talking, we are going to lose some truly valuable knowledge, practices, and, probably, some absolutely essential qualities like trust, truth, and justice.
So, let's stick with the particular against this background of generalities - why has the Government suddenly decided that the Health Professions Council is a good candidate to regulate the Social Workers? It didn’t ask the social workers, so who did it ask? In the absence of any information, it seems quite likely that this sudden announcement is a result of politicking behind the scenes by the HPC who need to secure increased income to cover its expanding inefficiencies. The lack of any rationale for swapping the social workers into the Health Professions Council is very worrying. If it is possible to change the Health Professions Council into the Social Work and Health Professions Council just like that, then it looks like the HPC is the puppet of ... politicans, who themselves seem to be the puppet of ... the HPC. Is anyone taking real responsibility here? Does anyone understand what's going on?
There appears to be no idea behind the move, and no idea to behind the HPC. It might be time to turn to an article recently published in the New Statesmen by a former diplomat, and Conservative MP for Buckingham 1983-97, George Walden. The article is a bold analysis of the character, or lack of it, of the prime minister. “Nowhere Man”, is published online at the New Statesman on 28 June 2010
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