HPC Council meeting, 31 March 2011.

I had two reasons for attending this meeting: to hear concluding business relating to the new Generic Standards (which will be reported elsewhere) and to listen to the discussion concerning the possibility that HPC would introduce Voluntary Registers. While I was there, a third reason popped up under the heading of ‘Any Other Business’: deliberations regarding the future involvement of the HPC in regulating counselling and psychotherapy. This turned out to be the most interesting part of the meeting, but its true import, in my opinion, can be revealed only by viewing it through the prism of what was said during the rest of the meeting. In this way it becomes possible to grasp the manner in which language and meaning are dissociated at the HPC. Slogans emerged and were repeated as participants struggled to build sentences out of a small number of phrases that had no reference point outside the group. In fact, they appeared to function in order to constitute the group. Which essentially makes the HPC an organisation best characterised as both self-referential and self-seeking.

The Council members had been invited by the HPC to attend a morning meeting to catch up on the implications of various new government publications (the change of status and name, the regulation of Chinese medicine and herbalists, the Command Paper). This may help explain why so many Council members (Malcolm Cross, Deep Sagar, Eileen Thornton, Arun Midha and a couple of others) did not attend the afternoon’s Council meeting. There is also a process of appointment and re-appointment going on, but it’s not clear how this would have affected attendance.

Michael Guthrie, the Director of Policy and Regulation (in this context, by the way, I think that label ‘director’ is highly misleading), submitted a report for discussion on voluntary regulation. Jeff Lucas (Professor of Health Studies and Deputy Vice-Chancellor at the University of Bradford) asked whether anyone knew what ‘assured’ voluntary registration meant before recommending, assuredly, that ‘we need to use this word more’. He might also have asked what ‘voluntary registration’ meant, since no one at the table seemed to have much of an idea on the subject. Julia Drown (a Labour MP from 1997 to 2005) observed that it would mean more money for the HPC. At the same time, she also pointed out that voluntary registration would probably command a lower fee, especially for the social care workers, who are amongst the lowest-paid people in the country. But this, she urged, should not divert attention away from the grave danger posed by such people, who often had the most intimate relations with those they cared for. No evidence was presented of any specific danger posed by social care workers and no one asked for clarification or chose to dispute her claim.

Penny Renwick, Associate Dean of Health, Psychology and Social Care at Manchester Metropolitan University, appeared to want to inject some common sense into the proceedings when she replied that the ‘poor old public’ would be hugely confused and wouldn’t understand the ‘various levels of protection’ offered by the different registers. She even said that a voluntary register might be a ‘chocolate fireguard’ and wondered how the HPC would measure its effectiveness. Then, as if someone had nudged her under the table, she said ‘but I do recognise that this is the direction of travel’ and that ‘potentially there will be higher levels of public protection’. Anna van der Gaag had recently encouraged the education and training committee (which contained many of the people present at the meeting) to embark on a journey without knowing the destination, and John Donaghy (Paramedic, Principal Lecturer at The University of Hertfordshire) had asked that they ‘put the boat in the water before we find the evidence’. They were then talking about standards for ‘user involvement’ in education courses, but the phrase has no doubt gained some currency and was used here by Penny to show that she was ‘in the same boat’.

Joy Tweed (a part-time lecturer at the University of Westminster), who was sitting next to her, was quick to correct her: ‘The challenge to us, then,’ she said, ‘is to communicate to the public. We need to make sure that voluntary registers do what they set out to do.’ She didn’t elaborate on what, exactly, that might be, or on how such registers might be distinguished from the HPC’s statutory registers. The problem here, it seems to me, is nothing if not considerable. For the past ten years, the HPC has depended upon being able to exclude someone from the register to convince the public that it is being protected. Now, however, a rewriting of history seems imminent if the HPC is to maintain what little organisational and philosophical coherence it possesses while also controlling voluntary registers.

Perhaps this was what Annie Turner (Professor of Occupational Therapy at the University of Northampton) had in mind when she offered what I think is a new phrase. She began in the traditional way, referencing the need to ‘capture the risk’, but when she specified the practitioners constituting the cause of the risk, she named them, interestingly, as those who ‘care not’ to be on the register. This manages to imply that those who do not choose the HPC are ‘care-less’. It also, it seems to me, commits the crime of stealing credibility from the altogether different and delightful character of Herman Melville’s Bartleby, who manages his lowly position through the beautiful phrase ‘I prefer not’.

Sheila Drayton (a consultant in professional and organisational development) said the voluntary register had fewer benefits since there was no protection of title. She also warned her colleagues of the dangers posed by care home managers. ‘No group,’ she added, ‘posed less risks than any others.’ She gave no reference to support this statement but appeared not to notice that, within normal protocols of meaning, she was also advancing the proposal that management consultants, Roman Catholics, blue-eyed boys, writers, poets, hairdressers, Uncle Tom Cobley and all would also need, one day, to be captured.

Mary Clark-Glass (a founder member of Northern Ireland’s Women’s Rights Movement) referred vaguely to her dreadful experience with voluntary registers in the fields of dry cleaning and estate agency in order to underline the need to ‘capture the risks’ involved. Mary has been a Council member since it began and might perhaps be expected to know that the HPC has never actually identified any specific risk or attempted to assess its own capacity to have an impact on any such risk.

Someone then asked what happened with voluntary registers in other countries, and a murmur of answers rippled around the table: ‘it doesn’t happen elsewhere,’ the UK ‘is unique in the world’. I eagerly await the research on registration in the solar system, the Milky Way, and the cosmos in its entirety.

Anna van der Gaag summed up: ‘we are gathering evidence, staying flexible – what we are looking for today is agreement in principle’. She clearly felt she had got it, though to the inexperienced eye, it only looked like she had done nothing other than move the agenda on.

The next topic proved controversial and generated some heat. The particular history, customs and practices of social work have led to the situation where students are also registered (at a nominal £10 per head). As the HPC has been given the responsibility for taking over this register, it has to figure out what this means within its context, the logic of which excludes students. Julia Drown, ever mindful of the great risk that people pose to each other, asked how the vetting and barring scheme operated in relation to students. I don’t know what relevance this had, and no one else seemed interested. Mary Clark-Glass seemed quite indignant and stated that the CHRE was ‘against student registration’. She even wanted to know what evidence there was that student registration ‘worked’. Then, really letting go, she asked, ‘Do we just do what a Minister tells us to do?’ The Council attempted to sidestep this outburst with a quiet and polite laugh. Meanwhile, Prof Lucas doggedly listed four reasons against student registration before demanding to know ‘what intended benefits are claimed for statutorily registering students?’ Di Waller (arts psychotherapist) agreed in principle, though I’m not completely sure what that principle was because she also said (and here it’s important to note the twist to the logic) that she wanted to ‘safeguard students on placement’. There is, I believe, a double trap here. She seemed to be agreeing with Council but at the same time disagreeing with them and agreeing with the Government proposal (which others had spoken against). Then she used the idea of regulation and registration as a method of protecting the practitioner – even though regulation and registration are actually supposed to protect the public from the practitioner (cf Julia Drown and Sheila Drayton). But even Di admitted it would be useful to see ‘the evidence’.

It is interesting to notice what provokes the Council to ask for evidence. Here, it seems they ask in the hope that it will help to protect them from the will of the Minister. Yet throughout the past three years psychotherapists and counsellors have been asking for evidence that regulation by the HPC would actually improve the level of public protection and have been consistently ignored by the HPC. Probably it is just a ploy, which won’t actually lead the executive to actually respond to the request; the HPC has never been interested in evidence and has not set up any processes to generate real evidence, preferring, as QC Dinah Rose said (when she represented the PsyReg group at the Royal Courts if Justice in December, in pursuit of a Judicial Review) to duck the hard work and pretend.

Richard Kennett (a chartered accountant) was, of course, worried by the £10 fee and concluded that ‘it must be subsidised by full registrants’, though he didn’t say what, exactly, ‘it’ was.

After all this hot air Mr Seale (CEO) told, or perhaps, reminded the Council that ‘the Transfer Order of 2nd April will give us the students’, and added that the HPC were looking for a grant from the DH to cover the costs. One wonders what the purpose was of the discussion, in the light of this timing and context. The process to register the Social Workers has in fact been ongoing for some time now.

The agenda imposed the image of order and cut the discussion off. Then, when the Council was being apprised of the fate of the anaesthetists (a group which had asked to be regulated by the HPC before the Government announced a halt to statutory regulation), Julia Drown piped up again and opened up the real problem for the group. She said she felt it was premature to say that statutory regulation is not available for any new professions. She seemed not to care – or maybe even to realise – that this view is in flat contradiction to the present Government’s Command paper, which clearly states an end to the process begun by the previous Government (of which she was a part, at least until 2005). She was neither supported nor contradicted in this section of the meeting, but the topic returned with a vengeance under ‘Any Other Business’.

One more thing is worth noting before we get to that part of the meeting. Kelly Johnson, Director of Fitness to Practice (again, I would caution against assuming you know what the word ‘director’ means in this context), remarked that in one of her reports ‘there is some language that has crept in’. An interesting phrase, I thought to myself. She was, in fact, referring to her use of the word ‘patient’ in relation to the audiologists, who apparently prefer the phrase ‘service user’. She didn’t say ‘I’m sorry, I made a mistake’ – she simply said ‘some language has crept in’. Poor old language! Reduced to creeping around at the HPC and promptly blamed when staffers stumble under the burden of so much linguistic legerdemain. George Orwell must be spinning in his grave.

Anyway, under the heading of ‘Any Other Business’, the Council finally turned its attention to the problem of capturing counsellors and psychotherapists. As is well known, the Command Paper issued by the Government in March made it clear that no new professions would be statutorily regulated, including counselling and psychotherapy (this latter point was set out in a footnote). The HPC wrote to Anne Milton (Under Secretary of State, DH) on 18 February to ascertain if this meant that there would be no statutory regulation for counselling and psychotherapy. Anne Milton wrote back confirming that there would be no statutory regulation for counselling and psychotherapy.

Here are two paragraphs from her letter: ‘As you have noted, the Command Paper Enabling Excellence makes clear that for the overwhelming majority of occupational and professional groups which are not currently subject to statutory regulation, including those groups recommended by the Health Professions Council for statutory regulation in the past, the assumption will be that assured voluntary registration would be the preferred option.’ She adds: ‘I can therefore confirm that it is not currently our intention to proceed with statutory regulation of psychotherapist and counsellors. However, we will keep this under review in the light of the experience of assured voluntary registration.’

If the HPC were a rational organisation, it might have conducted research into the prospects involved in a new product or line of work, considered the evidence thus collected and finally come to a decision. It might decide that the proposed venture was not viable, and that the costs already invested were ‘sunk costs’. ‘Sunk costs’ is a phrase from the language of accountancy and was no doubt invented to help get over precisely this problem: the organisation needs to find the time and method to mourn the loss of the hoped-for new venture and then to move on. If the HPC were not a rational organisation, individual members might mistake their place and promote their personal interest over and above that of the organisation, and then be unable to drop their objective. As someone from the onlookers said later, in place of mourning, melancholia might set in.

Jeff Lucas (a member of the Professional Liaison Group for Counselling and Psychotherapy) remarked that Anne Milton was merely reflecting the ‘politics of the day’. He said he would be ‘uneasy if we decide to abandon’ the capture of Counselling and Psychotherapy, adding ‘on the principle of public protection’ as if this actually meant something.

Let us pause for a moment to remember that at no point in the process (a protracted one that began in the summer of 2008) have the HPC looked for or produced one shred of evidence that the public will be better or worse protected through HPC statutory regulation. This was precisely the point on which Mr Justice Burton allowed the PsyReg group to proceed with their petition for a Judicial Review of the HPC procedures on 10 December 2010. The HPC agreed to write a letter of apology to the Secretary of State for Health for misleading him into thinking that the HPC had done the work necessary before it recommended itself as capable of regulating this field. It is to no one’s credit that the HPC Council, responsible to the Privy Council, continue to pretend that what happens in the High Court has no bearing on them.

Lucas stumbled on, bolting together ready-made phrases that, although still incomprehensible, nevertheless do reveal his personal investment in this matter and his reluctance to give up the prize: ‘…ignore the playing field... Statutory Regulation is not politics… public protection is still an option open to us... I would be reluctant to abandon, and would want to be active for assured voluntary registration.’

Mary Clark-Glass (another member of the PLG for C&P) joined in in the same way: ‘There is a compelling risk, and that, to me, tells me that the matter is still within our power and grasp. If we can show that patient safety is at stake, this will overrule the political wish. Otherwise it will be seen as closing the door, which is certainly not the case.’ She did not elaborate on the nature of the ‘compelling risk’ or on the source of the evidence that there was one. My best guess is that she is hoping to find a Dr Shipman lurking amongst the ranks of counsellors and psychotherapists which will trump logic, reason and politics and allow the HPC to romp home with their prize. It is worth recalling the warning Mr Seale gave to the College of Psychoanalysts when they visited him on 27 March 2009: the HPC would, he said, launch a media campaign to discredit them, using the message ‘Don’t use these people’. When it was pointed out to him that this would create a lot of protest, Seale replied – with glee – that ‘We can afford a better advertising agency than them’ (http://www.psychoanalysis-cpuk.org/HTML/HPCMeeting0209.htm).

Then Annie Turner (PLG member for C&P) picked up the theme: ‘The current climate appears to be through voluntary regulation, but we shouldn’t abandon what we have achieved. It would be a mistake. We have learned a lot, and we could use it to advance public protection. Let’s look at voluntary regulation. When we set it up, let’s look at standards, areas of risk, and assess whether voluntary regulation is appropriate. It would be foolhardy to abandon work we’ve done.’ What she can possibly mean by ‘we have learned a lot’ is anyone’s guess. Annie Turner constantly showed her inability to understand the issues at stake in regulating counselling and psychotherapy and consistently advised the PLG to invent standards that had nothing to do with current practice but that could, rather, fit the HPC. The PLG ended in disarray. Even after double time had been allowed, they failed to reach agreement on any of the basic questions – see the report by eIpnosis at http://ipnosis.postle.net/pages/LastPLGReportl.htm .

Of course, you won’t find this acknowledged at the HPC, and, as might have been expected, the chair of the PLG, Di Waller, said: ‘We have done what we have done for public protection, this has always been our remit, and I see no reason to abandon our principles right now…’ Mostly, what Di did at those PLG meetings was ‘park’ difficult issues, ‘put them in the pot’ until later, and postpone things.

While we are on the subject of principles, it might be worth remembering that the Arts Therapists recently wrote to the HPC saying that they had never considered the HPC Generic Standards as applying to them. Those standards are frequently cited as the method by which the HPC assures public protection. There is no evidence that they do, in fact, improve public protection, but this should not deflect us from the presence and acceptance of the cynical attitude here (reported in this blog on 3 Dec 2010, and published in Self & Society, vol 38, no 2, winter2010).

Then Mary Clark Glass, whose dander was still up, said: ‘We assess the risk, and we decide… We do not see this letter [from Anne Milton] as saying ‘no more statutory regulation’. To reflect a moment – it was at the first PLG meeting that a couple of observers in the ‘public gallery’ shouted ‘What is the source of your evidence?’ when two members in particular were playing fast and loose with statistics. At the second meeting, Mary Clark-Glass approached me with a pamphlet, and, riffling through its pages, stated that the evidence was ‘here’. I found none and was unable to persuade her to acknowledge this. She appeared confused and gestured vaguely at the pages before turning away altogether. It was one of many Kafkaesque moments I’ve experienced at the HPC. Exactly what she means by ‘we assess the risk’ is anyone’s guess. In the light of her radical rewriting of Anne Milton’s letter, we might expect it to mean ‘we do what we like’.

Three Council members with less personal involvement nevertheless echoed the tribal call: ‘we have a duty of care towards the public, we’ll do voluntary first, or statutory’… ‘step by step we’ll … proceed with assured voluntary regulation first, then …’ Finally Anna van der Gaag quietly assured the Council that they had concluded. She ‘summarised’ by saying ‘there is huge complexity, more work to be done, we have made an in-principle decision … our actions must be based on Public Protection, and that Statutory Regulation is still an option.’

On the steps outside the HPC, one attendee from the public gallery noted that the HPC were delusional in their misreading of Anne Milton’s letter. They had also managed to completely avoid any mention of the letter sent to Council members by the Alliance for Counselling and Psychotherapy, or from the Psychological Professions Alliance Group (PPAG), who wrote to say that ‘while we are exploring with CHRE the main option of a system based on the accreditation of existing voluntary registers, it would be helpful if HPC did not pursue for the moment the setting up of its own voluntary register. Such a move might serve to muddy the water of the dialogue we now need to have with CHRE’ (quoted from New Associations, Issue 5, Spring 2011, p2).

It is quite clear that the HPC has no interest at all in the real problems involved in the regulation of this group of practices, most of which depend on networks of knowledge and experience amongst its practitioners. In opposition to this, the HPC has declared itself willing to break the networks and has probably set in motion a process to seek a scandal to frighten the business into its nets.

In the meantime, the murder of language, the ongoing lack of rational discussion about the kind of regulation that is implied by the HPC and the absence of credible evidence in the decision-making process cry out to be addressed before any more business is passed its way.

Constructing the proposed new generic standards

This is based on the HPC Council meeting of March 25th 2010 (attended by Bruce Scott, from the PA). The long list of dense documents pertaining to this meeting can be accessed here:
http://www.hpc-uk.org/aboutus/council/councilmeetings/index.asp?id=523)

A private meeting followed in the afternoon (public excluded), which dealt with the Judicial Review.

Marc Seale (CEO of HPC) opened: registrant fees would probably be increased to fund the rising volume of fitness to practice hearings. In the accompanying papers the fitness to practice budget for 2010/2011 is estimated at £7,145,823! “That’s a lot of lawyers” thought Bruce to himself.

Seale also talked about launching a media campaign to create/push for the professionalism of the guys at football matches with buckets and sponges who run on to the pitch when a player gets injured. The HPC only want “professional helpers” who will then have be HPC registered!

He also wants to capture golf coaches and sports psychologists/coaches, saying ‘we have got to get them because some are not trained psychologists or sports coaches’.

Will the insidious nature of HPC regulation make its way into the Sunday kick-about with the boys or girls? Will “coaches” have to be regulated? Bruce used to be a racing cyclist: “I had several “unqualified” coaches throughout my career - they did it for free because they loved the sport and wanted to give something to the community: they were ex-cyclists, boxers, or just keen on endurance sport. Under the proposed HPC system my coaches would be not be allowed to get involved in sport coaching at all.”

The volume of papers the Council is faced with is overwhelming. I shall focus on only one, The Generic Standards of Proficiency Review Group – Executive summary and recommendations, http://www.hpc-uk.org/assets/documents/10002CED20100325Council-enc06-genericSoPsreview.pdf

These standards are applicable to ALL registrants across the 15 professions already regulated. They were shown to be wholly inappropriate for counselling and psychotherapy in the recent public consultation.

In brief: the Group recommended:
1) The generic standards applicable to all registrants should be kept.
2) But they should be BROADENED.
The council agreed.

The Group comprised:

Eileen Thornton (Physiotherapist)
Joy Tweed (Lay, Lecturer Health & Social Care)
Di Waller (Arts therapist)
Arun Midha (Lay, MBA)
John Donaghy (Paramedic)
Annie Turner (Occupational Therapist)
Penny Renwick (Chiropodist).

They met twice: on 28 September (ie before the end of the consultation on C&P) and then on 27/8 January 2010, after a ‘survey’ of 20 professional bodies. They were specifically advised (presumably by the invisible Legal Adviser mentioned in the report last week): “not to make changes specifically in response to the feedback received through the psychotherapists and counsellors consultation as these professions are not currently regulated by the HPC.”
In September 2009, HPC wrote to TWENTY professional bodies asking for feedback on the generic standards of proficiency. SEVEN responded: FOUR said they had nothing to say, ONE commented on the intro, not the standards, and TWO commented in detail about eight of the 25 or so standards. The Group thought this might indicate that on the whole most of the professional bodies covered by the HPC were satisfied with the standards. It would be interesting to know which two bodies gave the detailed comments.

Why is the HPC reviewing them if none of the existing Groups is unhappy with them? Is it because they want to capture C&P? But they are advised not to consult C&P in the process of revision.

Attachment B of the Review Group’s Recommendations summarises the additional information available to the Group and considered at their second meeting. Most of this information came from the consultation on regulating counselling and psychotherapy, and the rest relates to concerns raised by the psychologists. Neither of these Groups are allowed to be involved in re-writing the generic standards. The legal implications of any new standards for the time-table of work means that it will take years before the psychologists can re-write their specific standards (because the grand-parenting period has to be allowed to play out under the current, agreed, standards). If the PLG for P&C begin writing their specific standards before the new ones are finalised (they are due to reconvene on 12th May 2010, the new generic standards are predicted for January 2011); they too will also have to wait at least three years before re-writing can begin.

It is not noted that the huge number of concerns coming from these two Groups indicates the inappropriateness of including them in the domain of the HPC. Everyone in this field expressed forthright opposition to regulation by the HPC before the White Paper (Trust, Assurance and Safety) was published in 2007, an inconvenient truth that HPC tends to bracket off and ignore.
The report is presented with numbered sections suggesting an orderly progression of logic. However, on close reading one is forced to conclude that the numbering exists mainly for reference, much like page numbering. Could it be also that the numbers function to separate sentences from each other in order to ignore the flow of meaning and logic that some of them might present.

For example in para 2.2 the Group “[agree] that standards 2a.1-2a.4 are examples of when rewording the standards would still not make them applicable for all professions” because they do not apply to Arts therapists. The inconvenient truth that Arts therapists have not met these standards for 8 year is isolated in a numbered paragraph and ignored.

Meanwhile, the Group reflect on the history of the generic standards in the HPC. These were introduced when the HPC was created in order to identify commonalities across the professions. That this was only achieved by ignoring the anomaly of the Arts therapists is not noted.
It is again ignored in Paragraph 2.4, where “the Group agreed that the principle of having a set of generic standards of proficiency is important as they recognise that the professions regulated by the HPC do have commonalities.” To make the professions conform is the single most important task of this Group. But, apparently incapable of referring to real aspects of the work involved in the professions, the Group relies on generalised moral guidelines apparently of their own invention.

First, it is worth noticing how the re-write is justified. To recap, the Group must retain something called generic standards in order to justify the existence of the HPC as the single entity capable of regulation. But they know that these must be substantially rewritten if they are to succeed in capturing C&P. The existing professions have never complained, and don’t see the need to change. But the Arts therapists have taken this opportunity to say that, after more than 8 years, have never complied with these generic standards. As the HPC likes to justify its competence to regulate C&P by reference to its success with Arts therapists, this constitutes a considerable weak point.

This is probably why the admission is made, separated in a numbered paragraph, and then simply ignored.

So how will seven people rewrite the generic standards applicable to more than 205,000 people in 15 different professions? First they acknowledge that they can’t simply reword the current standards, because “some concerns go beyond wording” (2.1, p2). But this means that all other standards will also have to be rewritten, as the generic standards function as section headings in the overall document of standards.

In order to justify this huge project, the Group present three possible options and then choose one. This is prefaced with:

“The Group therefore agreed that generic standards should be retained, but that they should be as CONCISE as possible and applicable to the increasing diversity of professions and professional philosophies regulated by the HPC.” [emphasis added]

Note the use of the word ‘therefore’, which implies a logical argument, where in fact there is none. This small Group of people, meeting on two separate occasions, interspersed by a failed ‘survey’ of 20 professional organisations, are of course unable to do the job they have been tasked with. But instead of saying so (as the generic standards indeed would command) they seem to be creating a smokescreen behind which they are improvising wildly.

Preceding the word ‘therefore’ are four numbered paragraphs bluntly restating the imperative that HPC must have generic standards. The 5th preceding paragraph was the one that said Arts therapists have never conformed to 4 of these.

The word CONCISE has no meaning in the text, but seems instead to signal the Group’s anxiety at the amount of work, time, money and effort that this project will entail. All but the Arts therapists, apparently, are happy with the current standards.

What about the words BROADEN and EXPAND in the next section – what might they mean? Having recommended CONCISE new standards, the Group set out three options.
1. To make concise the old standards – rejected.
2. BROADEN the consultation of old generic standards to include principles and STRUCTURE of standards - rejected.
3. EXPAND the review of generic standards to include STRUCTURE of standards – accepted
This option (3) was chosen ‘because’
1. It would allow the HPC to engage with those who have an interest in the generic standards;
2. The HPC would be seen to be listening and responding to external feedback.
3. It would ‘future proof’ standards for potential new Groups;
4. A BROADER review would stand up to public scrutiny;
5. The work already done can feed into the BROADER review. (P. 4)

The rationale is blatantly political – if there is any sign of any other logic in the text, I couldn’t find it.

The Group goes on to consider a few different options for structuring the new BROADER generic standards:

1. Remove the generic standards, and allow each profession to compile their own. Rejected!
2. Group the generic standards under BROAD headings (eg Psychological Therapies, Scientists and Allied Health Professionals). Rejected ‘because’ it would be ‘complex and superficial’!
3. Change the structure to OVERARCHING, BROAD standards. Accepted because: it would give a set of OVERARCHING standards applicable to all; it would provide headings under which each Profession could then write its own SUB-STANDARDS (sic); the standard ‘be able to select appropriate personal protective equipment and use it correctly’ is likely to be retained for biomedical scientists, but is less likely to be needed for Arts therapists.’ Well, well, well – what a pitiful state of affairs.

Paragraph 2.19 lists six bullet points in an attempt to justify why this option is the most appropriate. These points are an object lesson in how to rob words of any meaning and muddle and confuse the reader to force through the forgone conclusion. Here they are in condensed form:

1. Keep generic standards;
2. There are 14 [sic] diverse professions but there are some commonalities that the generic standards recognise;
3. The OVERARCHING generic standards can be interpreted by individuals;
4. It solves terminology problems allowing difference to be expressed within the professions, own standards; the new structure can be rolled out, beginning with the most problematic professions; new professions will fit.

This meaningless jumble of words leads directly to RECOMMENDATION 3: to adopt OVERARCHING generic standards with profession specific sub-standards underneath. Sub-standards?

The proposed 15 new overarching generic standards (yet to be tweaked by executive and legal advisor) can be winkled out of the HPC website here. http://www.hpc-uk.org/assets/documents/10002CED20100325Council-enc06-genericSoPsreview.pdf

Last Friday saw the first full read through of Josh Appignanesi’s new play Therapy! at London’s Vaudeville Theatre. Matthew Lloyd directed the cast

Richard Schiff – The Shrink
Alex Jennings – The CBT
Jessica Raine – The Analysand
Amanda Drew –Wife
Tom Goodman-Hill –Husband

Particularly impressive were Richard Schiff, instantly believable as the psychoanalyst, and Jessica Raine (the analysand trying to get the best of both worlds by also having CBT). Food provided the linking theme, and the action shifted between consulting rooms and dining room, presenting political points, sexual politics, problems of identity and rivalry, hilariously. It was a real privilege to watch five professionals turn our dilemma into a satirical workout for their talents. (Thanks to Julia Carne, CFAR, for contributing to this.)

State regulation of the psychologists, quis custodiet ipsos custodes

The Joint Committee on Statutory Instruments now has an Order to consider which, if passed, will put 13,000 psychologists onto the register of the HPC in July. This order is called The Health Care and Associated Professions (Miscellaneous Amendments and Practitioner Psychologists) Order 2009. It is simultaneously laid before the Scottish Parliament.

The Order relates to the General Dental Council, the Health Professions Council, and the Royal Pharmaceutical Society of GB.

It includes governance changes which will effect the Council of the HPC. At the moment, HPC Council is made of members who are elected by the 13 professions already on the register plus 13 lay members who are appointed by Privy Council. This Order will remove the elected members and all will then be appointed by the Privy Council.

The power is moved (yet again) away from the people who practise, to a private group appointed by the Sovereign.

The explanatory memorandum puts it like this:
it is "to ensure that purely professional concerns are not thought to dominate its work"
"Regulators must be seen to be independent and impartial..."
"Doubts based on a perceived partiality have threatened to undermine .. trust"
"The regulators may be seen as partial ..."
"The composition is central to .. these perceptions"
"Regulators may be seen as partial to their professionals because [they] form the majority of their council or may be seen to be partial because their councils are thought to be elected to represent the particular interests of health professionals. Hence the moves to parity of membership and having independently appointed councils rather than professional members being elected by the profession." (Clause 7.1) [emphasis added]

There's a few things to note: these excerpts are all about manipulating an image rather than reflecting or establishing a system grounded in reality. It would be valuable to ask 'not thought by who?', 'perceived by who?' 'seen by who?', and 'on what occasion'? The vagueness does not encourage clear thinking. Second, the idea that purely professional objectives are a bad thing is odd. It sort of implies that the particular interests of health professionals are primarily against, and dangerously against, the interests of someone else. The vagueness leaves a nasty taste and encourages suspicion - abstract suspicion. Thirdly, the structure of the HPC is already predisposed towards destabilising the knowledge and practise of each of these groups of people, which makes it more likely that a group would to try to act in its own favour, to protect its boundaries, and to redefine its speciality - and all these things have already been insinuated as bad. An effective self fulfilling prophecy has been put in place which this new Order can only add to.

Couple this with the realisation that 13000 new people could be added to the register in summer, and that these people are working with other people's minds, and you have quite a prospect.

Quis custodiet ipsos custodes - who will guard the guardians of the psychologists? The question has an infinite regress, remedied here by ... the Queen.

The actual HPC Council meeting, Feb 2009

The 30 minute meeting was extraordinary for the lack of debate and discussion. Not all of the papers had been ready before the meeting and a couple of them were handed out, one in particular was presented to the group and 5 minutes were designated for reading. This paper had been written by the Department of Health who are apparently all of a frenzy these days, and hadn't got there act together. The Council Members duly bent their heads to consider this important document. A lacklustre attempt to comment followed, and was met by a robust rebuttal from the resident lawyer.

This lawyer turns out to be none other than Jonathan Bracken, a partner at Bircham Dyson Bell. This is the man credited with writing the documents that brought the HPC to life (see blog below headed 'The Information Commissioner'): the Father of the organisation. He was in fine form, probably the only member of the meeting who hadn't just spent 5 hours in brainstorming future strategy and expansion. His joke related to another new short document, on which the increases in fees were written. This must pass through parliament. He informed the meeting that altho the document was just being handed round, in fact nothing on it had changed since their view of its draft. This of course was good, he quipped, except he might have liked to have seen the figures increase. He laughed "hahaha".