Finance, Fashion, Security, and the death of philosophy

I popped into the HPC yesterday to catch the first hour of the Finance Committee Meeting. As I walked up the stairs to the front door I noticed a really pretty circle of shiny steel within which a bright blue light changed to lime green as I was let in. There was another by the internal door that serves as the entrance to the main part of the building. I remarked on them to the receptionist, and noted more and more of them as I was escorted down the corridor to the bright and airy council chamber in which the Finance Committee had already commenced its business. There, Brian Walker had taken the guest seat at the square table, around which the committee and its servants sat, and was talking about the falling value of the building. Around the table, the Council members were sitting with their new sleek, metallic light-weight lap-tops. Those with thick spiral bound sets of paper were probably the staff. Everyone in the back row (except me) has one of these spiral booklets balanced on his pin-striped knee.

Mr Walker was talking of the effect the recession was having on the value of the building. He said several times that it was the best quality office building in the area and I remembered hearing exactly this talk at another Finance meeting perhaps a year ago. He said the market was ‘bumping along the bottom’, and he ‘did not foresee an improvement’ next year, ‘the market place is what has to drive us’ he said, and ‘this is where we stand’, etc. Julia Drown asked ‘should we sell up and cash in?’ He replied that that Freeholds weren’t selling at the moment, because no-one’s got any money. There was a short detour about the number of millions it was now possible to raise compared to the squillions that were the norm more recently. Nevertheless, he reassured the Council that their ‘covenant’ was clearly very strong, because it was effectively Government backed.

“Should we sell the building and lease it back?” The council member asked. “Should you occupy a freehold?” repeated a startled Mr Walker, “it’s relatively unfashionable, because it is so cheap to lease”. No, then, I suppose.

Malcolm Cross asked if he could ask a naïve question. He was assured he could. “Is it possible, if the organisation grows organically, and colonises different spaces around the neighbourhood, to reconsolidate later?” “Yes” said Mr Walker who was then free to leave.

This made room at the table for Jonathan Bracken, the Legal Adviser, and a young woman who seemed to be making her debut at the meeting – Kathryn Neuberger, the Partner Manager of the HPC. She tentatively read the document relating to Item 11 of the agenda: Partner Code of Conduct and my notebook filled up with legal phrases: Code of Conduct, Contracts Compliance, Specific Conduct, Revised Code. Partner Code of Conduct. Someone asked what had provoked this revision, “had there been a spate of complaints about the Partners?” “No. We only get about 2 complaints a year”. “Oh, who from? Other partners perhaps, or from HEIs?” Kathryn didn’t know, so it probably wasn’t the reason for revising the contracts and codes. We didn’t learn what was, nor why it was here in the Finance meeting. Jonathan Bracken added some serious sounding stuff the only part of which I could understand was “making sure people keep up with training requirements”.

Malcolm Cross apologised for wanting to ask ‘another probably stupid question’, and was again assured it was ok. He was puzzled about the complaints procedure, and was unsure what was meant by the contractual obligation to act in ‘good faith’. This prompted a breeze of laughter after which Jonathan Bracken recovered himself and affably said it was “one of those things one instinctively knows but cannot be put into words”. Business done he then bustled out of the room with a huge grin on his face.

Everyone turned to the pages full of figures – The Finance Department Report, the first page of which details funds under management of £6,100,000 plus 2 investment portfolios amounting to £4,010,000. That’s over ten million pounds of money tied up in investment accounts earning various rates of interest.

Revenue of nearly £15 million is received through registration, but was slightly exceeded by expenses. There are two notes of particular interest offered as explanation for the overspend:

1. Professional Fees. “The unfavourable variance of £238k is mainly due to an unfavourable variance of £60k for legal advice due to additional advice in relation to new professions, an unfavourable variance of £62k for other legal costs due to a [sic] increase in high court appeals, and unfavourable variance of £58k for transcript writers due to the increase in the number of hearings and an unfavourable variance of £49k for legal expenses due to an increase in disbursements and costs relating to Psychologist Hearings.” (Note I p 4,).

2. Fitness to Practise. “The unfavourable variance of £612k was due to an increase in the number of allegations being received and the increase in the length of hearings. This included unfavourable variances on room hire (£65k), panels (£394k) and transcript writers (£58k). There was also an unfavourable variance of £62k in other legal costs due to the increase in high court appeals.” (Note 7 p 6.)

A couple of other small amounts turned out to be equally as interesting. A figure of £90,000 revealed a point of fear and trembling for the HPC. Once upon a time, the HPC had bought a licence for its Microsoft Software, but the piece of paper that accompanied this act has long since been lost. The HPC is worried at this lack of proof of their virtue. If Microsoft ever comes knocking on the door to demand to see the licence, it will have nothing but a word of honour to offer. The finance team didn’t think Microsoft would believe them. So, they have been salting away a few thousand a year against the day of judgment. Finally they decided to go out and buy fresh licences and be done with it. So, there does exist a body capable of frightening the HPC. Very Old Testament, I must say, in a 21st Century kind of way.

The second interesting figure is £360,000, concealed in the cash flow accounts where it appears as an exceptional expense, written in brackets to signify that in fact it is an income (September 2008). It is a payment from the Department of Health. I am currently trying to discover what this signifies.

Just before I had to leave, Marc Seale was explaining that he was expecting ten times as many Fitness to Practise cases on the books when they took on Psychotherapists and Counsellors. This was, he said, because there are about 40 or 50 organisations out there, most of whom lack proper fitness to practise processes, so it’s a major issue which he is currently negotiating with Government – the extra costs he foresaw pertaining to P&C FTP shouldn’t be passed on to the existing registrants and another source must be found.

NB Paramedics are disproportionately represented in FTP, though no similar logic is applied there. Perhaps the HPC are making the DH pay for the inconvenience they are experiencing with this ‘New Profession’.

It was much later that I remembered one more point while watching the premier of the film Erasing David (to be televised on More 4, 10pm Tuesday 4th May). The film, sponsored by the Joseph Rowntree Reform Trust (who launched last year’s Convention on Modern Liberty), is an experiment designed to reveal the amount and kind of personal information held on databases. It is also a study in creeping fear, and a reminder of the role played by the rhetoric of security which justified so much legislation, including that which created the HPC. One scene in the film jogged my memory back there. It was a scene in modern school which used finger-print technology to take the daily register. A beautiful shiny metal oval contains a blue light on which each pupil presses their finger on entrance to the class. It reminded me that Malcolm Cross had raised a very tentative question, for which he apologised profusely, about the figure for Access Control on Additional Doors (Budgeted at £9,400, Actual, three times that: £27,757). Marc Seale had, in his customary way, rattled off the security rationale for this, and moved on. Apparently there had been a break-in, so they had decided to increase the security to make sure everyone was safe inside the building. Dr Cross ventured to ask again “and I suppose a proper discussion was had at the time?” Oh yes, said Mr Seale, and this time closed the conversation stone dead.

Thanks to Ian Parker (CFAR) and Simona Revelli (The Guild) who have both brought the bad news that Middlesex University’s renowned Department of Philosophy has suddenly been closed down. Article Guardian online here:

and petition against the closure here:

Link to Richard Gombrich’s prophetic article from 2000 British Higher Education Policy in the last Twenty Years: The Murder of A Profession. Here:

And Paul Verhaeghe’s keynote paper Chronicle of a Death Foretold – the end of Psychotherapy, can be googled and downloaded from the Dublin City University Health4Life Conference 2007.

Art, literature, and bureaucracy

Picking up the Archbishop’s thread from Easter Bank Holiday Monday – can literature defeat bureaucracy? – I’m sorry to report that there was a clear win for bureaucracy at last weeks International PEN meeting ‘Free the Word’ at London’s South Bank. Internationally celebrated writer Donato Ndongo-Bidyogo (a political refugee currently living in Spain, exiled from his home in Equatorial Guinea) was denied entry into the UK to take the stage on Saturday because the beleaguered bureaucrat got tangled up in the red tape of the new border control agencies (UKBA, formed in April 2008). Donato had applied to enter as a ‘business visitor’, but the poor fuddled civil servant got hopelessly lost in the labyrinth of rules and ended up quoting chapter and verse from the wrong page of the book. Donato was rejected without hope of appeal and thus prevented from entering good old bastion of liberty, free speaking Britain.

The Labour Party Manifesto links this new agency with crime reduction policy in chapter 5 entitled Crime and Immigration. “Our borders are stronger than ever” it declares, though it may simply be that piles and piles of red tape are simply in the way. This “new Border Agency has police-level powers and thousand more immigration officers, 100 per cent of visas are now biometric, and new electronic border controls will be counting people in and out by the end of the year… Genuine refugees will continue to receive protection.” Or not…

In the absence of Donato Ndongo-Bidyogo’s bodily presence, someone read a passage from his book: Shadows of your Black Memory (Swan Isle Press, 2007), around about page 84. Told in the voice of a boy this piece describes him watching with glee as his Uncle, the leader of the tribe, sparred and jibed with the visiting Catholic Priest whose mission was to impose his superior culture on these poor guys who were evidently stuck in the dark and dismal past. The Uncle’s work was to constantly subvert the Priest’s mission by reminding him to practice what he preached. But the Priest was deaf to his witty reminders and carried on obliviously. The justifications for the Priest’s unwelcome rescue package were uncannily familiar and reminded me, of all things, of the HPC. A man convinced he is right, and employed in a state backed institution excuses himself the effort to think and takes pleasure from telling the other how to live.

Which reminds me, I received a letter from Marc Seale today, replying to the letter I sent following Malcolm Cross’s hearing in which I asked a series of questions about the way the HPC conducts itself. Mr Seale quotes chapter and verse from his big book of rules to prove that I am wrong to raise these questions, and invites me in for re-educating.

Last night at the National Theatre, Alan Bennett’s play, The Habit of Art, (in which, by the way, Alex Jennings, who read the part of the CBT therapist in Josh Appignanesi’s play Therapy! plays the Benjamin Britten) was filmed and broadcast live across the world to thousands and thousands of people. Fabulously rich, layered, funny, thought provoking, intelligent, and mysteriously moving this play sent me off to discover Auden on You Tube reading his poem In Memory of Freud in which so many lines are worth quoting but these especially:

If he succeeded, why, the Generalised Life
Would become impossible, the monolith
Of State be broken and prevented
The co-operation of avengers.

Other lines also reminded me of Therapy! whose most moving scenes come in the analytic session when, between them, analyst and analysand managed to find the truth that Auden puts like this: “to be free is often to be lonely”. And,

But he would have us remember most of all
To be enthusiastic over the night
Not only for the sense of wonder
It alone has to offer, but also

Because it needs our love…

Literature alone doesn’t solve it, of course. Bennett’s play was very different from that of Mark Haddon currently playing at the Donmar – Polar Bears. This one tries hard to look directly at Bi-polar living with the help of philosophy, post-mortem anatomy, and post-modern style. Although engaging in parts, the cut up nature of the play gives everyone the chance to avoid asking themselves what the hell they thought they were doing. It gave a glimpse of the world in which Sigmund Freud’s work was already long forgotten.

In Auden’s poem, written in 1939, he could say of Freud

To us he is no more a person
Now but a whole climate of opinion.

Climate Change, apparently, has evaporated his wisdom.

Only Hate was happy, hoping to augment
his practice now, and his shabby clientele

At the Dulwich Village yoga class on Tuesday evening two women talked enthusiastically about what they’d learned on the Radio 4 programme “Between Ourselves” earlier that morning (9.am, 20th April) in a discussion between Oliver James and Laverne Antrobus. If a baby doesn’t receive the right amount of love, they said, then the brain does not develop, and there’s nothing more to be done. They went on to explain that this was the reason for Jamie Bulger’s murder. Listening again (on iPlayer) Oliver James (who I learned is the son of two psychoanalysts) didn’t exactly say this, but the general drift of his interventions take us directly into this difficult water and look very much like the current climate of opinion.

Back in the Manifesto, in a section of chapter 5 (Crime and Immigration) entitled Early Intervention and Preventing Crime, the Labour Party boldly state: “We need to do more and act earlier to stop children going down the wrong path. So we will expand Family Nurse Partnerships to all vulnerable young mothers, reducing future crime and behavioural problems. For the 50,000 most dysfunctional families who cause misery to their neighbours, we will provide Family Intervention Projects – proven to tackle anti-social behaviour – a no-nonsense regime of one-to-one support with tough sanctions for non-compliance’. All three major Party Political Manifestos contain a line or two about mental health. Labour promise to provide ‘access to psychological therapy for those who need it’. The Liberal Democrats say they will ‘improve access to counselling for people with mental health problems, by continuing to roll out cognitive and behavioural therapies’. The Tories will ‘increase access to effective ‘talking’ therapies.’ The question remains in all cases, however, how these policies relate to the State. In particular, who defines mental illness, who defines the talking therapy, the behavioural adaptation, the cognitive modification, and how the practitioner who delivers this policy is going to be policed.

The Institute of Group Analysis, in the 7th edition of their newsletter Dialogue (March 2010) illustrates how the insipid creep of the modern British State infiltrates even (!) analysed minds. At their conference (Can Group Therapy Survive NICE: Examining the Evidence) Glenys Parry and Chris Blackmore presented their findings from what is known in these circles as ‘a systematic review’. They were searching for ‘evidence’ of the ‘effectiveness’ of psychodynamic group therapy and group analysis, something they described as ‘difficult’ in the ‘deluge of articles picked up by their search terms’. Nevertheless, they were able to conclude that there was, indeed, broad and consistent evidence for the aforesaid therapies, tho ‘insufficient to distinguish between the various group therapies, and, get this, ‘insufficient randomised controlled trials’.

And thus they can conclude, this puts them ‘in the position of not being able to make a case for inclusion in NICE guidelines apart from in a combined treatment for personality disorder.’
What do do? Chris Mace ‘usefully’ suggested that they do a Cost Benefit Analysis on their Group Analysis! Apparently the Powerpoint presentations can be accessed from the IGA website.

Perhaps you too have had experience of doing a systematic review. You will know that it is made possible by the powerful computerised search engines ploughing mindlessly through databases to pick up keywords across disparate fields. The quantity of papers that line up to be read is literally mind-blowing. Each paper, once a pearl of wisdom situated in an agonistic field, is plucked from its context and thrust into a such a heap that difference, meaning and value are reduced, mashed and beaten to a pulp and any goodness is utterly destroyed.

Perhaps you too have had experience of learning a poem off by heart, or of learning a part in a play. You will know that it is only possible by constantly going over one text. Could there be two more different approaches?

Auden, again, on Freud:

He wasn’t clever at all: he merely told
The unhappy Present to recite the Past
Like a poetry lesson till sooner
Or later it faltered at the line where

Long ago the accusations had begun,
And suddenly knew by whom it had been judged
How rich life had been and how silly
And was life-forgiven and more humble.

The whole poem is well worth a longer look - published by Faber and Faber in the collection Another Time.

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.)

The Mystery of FTP. Andrew Marr, Archbishop of Canterbury, Philip Pullman, Mona Sidiqqui and David Baddiel help us to think about the HPC

The big idea written into the circuitry of the HPC is that professional organisations have vested interests which render them unfit to be given statutory power and to conduct their own regulation. Only an organisation free from vested interests is capable of dealing objectively with regulation says the One with the big idea.

This assumes that there are other kinds of organisations that do not have vested interests. Thus a central and longstanding problem is dismissed at a stroke. This blind spot at the heart of the HPC is identical to that which gives prejudice its energy. It gathers together a set of people and separates them from other people through the application of a negative characteristic. Written into the law is the idea that professionals are not to be trusted to regulate themselves, HPC functionaries are.

Before 2001 it was enough for politicians to say ‘we don’t think these professionals are ready to be handed statutory power’. A strong reason for this was the lack of a coherent body of knowledge to bind the field into one. Now it is said that we can make the field into one by defining it as a threat to the public, and then creating a new statutory body to police it.
The HPC appeared as the one organisation incapable of corruption. The benefactor of its virtue was The Public whose vigilance against sinful aspects of itself was needed to make the thing work.

The idea that the HPC is incapable of corruption is linked to the idea that it cannot think for itself but gets its instructions from something unnamable and powerful. This might explain why the professional links to the HPC are largely shrouded in mystery. There are three sacred tomes: Standards of Proficiency, Standards of Education and Training, and Standards of Conduct, Performance and Ethics.

Any problems associated with these three great questions are swept aside with a combination of strategies: consult legal advisors; appoint friendly panels of experts; set up bureaucratic procedures which are somehow not of their own invention nor subject to their influence.

Each of these routines can be seen at work in any of fitness to practise hearings. Today’s example is of a complaint that was prevented from entering the process. This is a part of the picture that rarely gets exposed, but it is nevertheless instructive in that it reveals once more revealing the way in which the HPC interprets its mission and reveals what it considers a sin.

It is worth holding in mind the recent case of psychologist and HPC Council member Malcolm Cross (an excellent report of which is posted on the HPC watchdog blog, written by Bruce Scott). The contrast reveals the working assumptions about the nature of the public the HPC feels it worth protecting, about the kind of sin that it needs to protect the public from, and also about the potential for vested interests to make themselves felt.

The setting, as usual, is the NHS. An employee suspects he is about to be downgraded when a manager re-writes his job description. There is a specific clause in the job contract forbidding unilateral changes, and he suspects the manager is trying to avoid a redundancy situation. He complains to a more senior manager who sits on the paperwork and does nothing about it. The employee (who does not belong to a trade union) engages a lawyer and complains to the Trust. He is vindicated and the managers are prevented from breaking the law. A few weeks later an incident arises at work and the two managers use it to effectively get rid of the thorn in their side. So the employee complains to the HPC that the two managers are acting unprofessionally – the main contention was their intention to break the law by rewriting the job description and failing to activate a grievance.

If Dr Cross’s dinnertime antics register as a possible harm to the public, why does this case not also make the HPC alarm ring?

Here is what the HPC said: “I … understand that both complaints were closed on the basis that the concerns you raised were not considered to relate to the registrants’ fitness to practise as registered professionals.”

The letter is signed by the head of case management who explains that someone else has given her to understand that, following due process, they have judged that the actions are nothing to worry about. She continues:

“Please be advised that your complaints were closed following legal advice from the HPC’s legal advisor. The complaints were not considered by a Panel of the Investigating Committee.”

There is something curious in the form of the letter. In a Humpty Dumpty way she writes: legal advice was gotten from the legal advisor. In repeating the phrase she avoids saying who is actually responsible here, and conjures up the mystery of He whose name cannot be spoken. The repetition effectively creates a screen behind which we may not go. We have to trust that this manager has the experience and wisdom to know that this ok, but we know nothing about her nor how she’s been put to the test. The legal advice also stops the complaint from entering the formal process – it does not go in front of the Panel of the Investigating Committee (populated by registrants and lay-people recruited and trained through the HPC).

She continues:

“I am of the view that the complaints you made against X and Y do not raise public protection issues …

The emplyee’s point was that x and y were trying to over-ride the law to implement their own, local, agenda, and might have used the power of the institution to damage his own less powerful position.

“I am satisfied that your complaints were investigated fully and dealt with appropriately …
Investigated fully? It was legal advice from the legal advisor, not Investigation by the Investigation Panel.

… “Should you remain dissatisfied with the HPC’s decision to close your complaint, it is open to you to make a complaint via the HPC complaints process.”

Such convolutions do not inspire confidence, and neither does the fact that the complaints manager is another HPC employee.

“You should address your complaint to: Mr Greg Ross-Sampson, Director of Operations, HPC…"

Presumably Mr Greg Ross-Sampson will go to the same legal advisor for legal advice and catch our complainant in the same infernal loop.

This complaint has many aspects, and the situation remains in dispute. One of the complications is that the complainant discovered that the manager he was complaining about was the chair of his professional organisation. He now suspects that the manager’s position in the hierarchy, coupled with his liaison with the HPC, has effectively scuppered his complaint. The promise of protection was offered, and this public was disappointed. No ameliorating mechanisms were put into play.

Andrew Marr nailed the problem within the first few minutes of Easter’s Start the Week (BBC R4, Monday, 4 April 2010). In conversation with the Archbishop of Canterbury, Marr said ‘It seems to me that the core of the problem is that of being an institution, because every institution wants to protect itself as an institution’. This, of course, is not news (Max Weber said much the same thing about a century ago), but perhaps more interesting is that Marr was talking not only to Rowan Williams but also to Philip Pullman whose new book (The Good Man Jesus and the Scoundrel Christ) novelises exactly this dilemma. “What we are talking about is the difference between the institution and the essence,” said Marr. Rowan Williams thought a central theme of Pullman’s books was the question of the ‘price you pay for transmitting, in institutional terms, the message’. Pullman thinks the price too high, Williams does not.

Prof Mona Siddiqui tried to elaborate on this difference by reminding everyone that these differences of opinion exist amongst many religious. For example, the Sunni and Shia sects of Islam have almost opposite relationships with bureaucratic structure. Unfortunately, her point was lost as soon as Marr asked: ‘Is it possible to have an effective religion without a huge bureaucracy? To which Williams replied: ‘You need some way of recognising from generation to generation that you are talking about the same mission’. The question became: ‘Does the religion, does the structure, have enough in it to rein the people back from less relevant ends?’

David Baddiel (whose new film The Infidel directed by Josh Appignanesi is out this week), said the urge to institutionalise, along with the tendency to split and form schisms can also be found among atheists.

Mona Siddiqui raised the question of love by distinguishing between institutional expressions of religion (which give context and reference points for people to make sense of it), and the creation and exploitation of sacred leaders. Again, the point was left when Pullman set off on a slightly different tack: ‘There is always an original visionary who speaks about a time that will be coming soon when heaven will be fulfilled and earth will be full of plenty. Of course it doesn’t happen, so an institution is set up in order to validate the vision’. He could have been speaking of politics.

Both Marr and Williams picked up the thread and talked about rules, codes, tick boxes, and the collection of scores to ‘prove’ the truth of the vision. Williams thought ‘this is one of the things that the gospels do try to undermine’, and a bizarre wager was made when the writer pessimistically bet on bureaucracy to always trumps literature, and the Archbishop (optimistically) backed literature to triumph over bureaucracy.

Baddiel thought that the function of bureaucracy was to inject the greater truth into the story and noted how some people could then cash in on the power. Williams thought that this was too instrumental a version, and that it gave people too much intentionality. It is not, he said, really the way a lot of these things start out. But he might have conceded it was the way that a many things proceeded, especially when cut off from the original plot.

But then a pearl of wisdom was dispensed. The Archbishop said: ‘Something happens that releases an explosion of puzzles, more than language can cope with, which leads to a very complicated period. This is when you begin to see the start of bureaucracy.’

He could have been speaking of a pregnancy, a terrorist attack, the triggering of a psychosis, or the conception of the HPC.

Invitation to HPC registrants & co

During the last year several people (registrants of the HPC and their clients, patients and employees), have contacted me to tell me about their dreadful experiences with the FTP processes.

One woman was being 'tried' for the third time for the same 'crime' and was well beyond the end of her tether. The patient had complained to the NHS who had listened and decided there was no case, then to the Quality Care Commission, who had listened and found there was no case to answer, and then to the HPC who had ... put their machinery into operation, heeding neither the NHS nor the QCC, nor even their common sense, only to find, months and months later, that ... there was no case to answer. Three times! For exactly the same complaint!

Another case was of a very well known and respected woman who had herself raised a question about the staff in an agency where she once been contracted to work. This irked the agency who found their way to complain about her in their turn. After months and months of work, and loads and loads of money, the case was finally dismissed.

There is a complaint from an individual against one of his NHS bosses. This boss turns out to be a senior member of the profession, a regular visitor to the HPC. The complainant was (therefore?) told there was no case... However, he continues to hold onto the logic of his case, and writes to the HPC regularly. He is trying to call them to account, and is pursuing his argument tenaciously.

Another woman has been trying to get a response from a registrant whose work damaged the relationship she had with her son. The HPC have no resources to offer her, and can only add to her increasing distress.

There are more. Those caught up in the FTP process are very unwilling to tell their story in public for fear of retribution from the HPC. Others are so immersed in the turmoil that writing about it is the last thing on their minds. People I've spoken to after the hearing is over usually just want to disappear back into their lives and try to rebuild their relationships and routines.

This is simply terrible. What is there to be done?

Many people exclaim: it's a waste of tax payers money!

But before dismissing this as untrue, it's really worth thinking about this in detail. The fee that the registrants pay must be agreed in parliament and passed by law. This fee is then levied exactly like a tax. However, the familiar cry: No Taxation Without Representation is not heeded here. The registrants of the HPC cannot vote on the way the money is spent, and cannot call the officials to account for wasting the money they have paid them. It looks more and more like a stealth tax, and one without representation!

A few people have suggested that I open up this blog to other writers and make sections for each of the different professional groups (15 of them at present in the HPC). If you know someone who would like to write an entry, do encourage them to get in touch (click my name in the Contributors Side Panel at the bottom of the list to find my email address). My aim here is to expose the mechanisms of harm, and to show through actual examples what is really going on. It is this kind of real evidence that can convince people gently, and that can even produce a pacifying effect to the otherwise pernicious experience. It's an appeal to natural justice, with the aim of learning from the mistake (no matter who made it) and of making things better for others in the future. At the moment, the HPC is wasting opportunities for learning, and turning local spats into major incidents; this is very negative overall.

In the meantime, anyone can post a comment on any of the articles already here, and these comments can be anonymous. I am more than happy to engage in a conversation, if you are willing to take the time.

Janet

Judicial Review of HPC and The Merits of Statutory Instruments

The proliferation of symptoms in the body politic presents too many different choices to focus on, and many of us just want to turn away and get on with our life and our work. Those who do manage to stay looking at the gorgon get tangled up in debates about the best way forward. There are those of us who want to mobilise colleagues to take an active stance wherever they are: at work, with their MPs, in their training and umbrella organisations. Others are good at writing to the newspapers, intervening in blog debates, or inventing alternative accountability strategies. One has even written a play (see below)! It is difficult to say what act is having which effect – but surely the more that people are acting according to their own abilities, ideas, and local opportunities, the better it will be.

There are two ends of a legal line that represent different positions to take up influence on which are worth looking at again in more detail: The Judicial Review and Merits of Statutory Instruments Committee (MoSIC).

First the JR. As you know, several psychoanalytic training organisations have instructed human rights lawyers (Bindmans) to begin a judicial review of the HPC, and are campaigning for support for this. At the end of this report you will find details of a fund raising event (a new play based on the current shenanigans: THERAPY, by Josh Appignanesi, Friday 9th April). And if you go to the hpcwatchdog.blogspot.com you will find the text of a letter that is full of information that you can use to send to your MP (and prospective election candidates) to keep them up to date.

In brief: in the last few days it has been confirmed that the JR has stopped the Department of Health from drafting the Section 60 legislation that is necessary to pass Counsellors & Psychotherapists onto the HPC register. However, it has also probably antagonised the HPC (and its supporters) and put them onto a more aggressive stance. For example, in recent visits to HPC HQ Bruce Scott (from the PA) and I have noted Council Members and HPC Solicitors (Kingsley Napley) more insistently pushing the message that the British public has much to fear from the skilled workers in this country. By the way, please read Bruce’s excellent account of Malcolm Cross’s FTP hearing. http://hpcwatchdog.blogspot.com/2010/03/guest-post-by-bruce-scott-on-ftp.html

The JR may also have provoked the arrival of a new campaigning group (INTEGRITY, or ISRPT) – whose eagerness to pacify the state and offer themselves up to the HPC machinery has prevented them from noticing that HPC is not at all what they demand. They think that they can change it to fit after the law has been enacted!

Perhaps more surprising is Mind’s publication of a snapshot poll which suggests that lots of its members want to complain about counsellors. This has been spun as ‘evidence’ and reproduced in full on the BACP and BPC websites. It is, however, in contradiction to what CE Paul Farmer said in October last year, and which was reported here, in PP41, 20 January 2010.

The gap between the wishes of centralised staff and those of local working people seems to be getting larger – a trend that is expected in an era of state centralisation. Evidence of this is also emerging in the huge new super-sized trade union – UNITE (created by a merger of TGWU and AMICUS). It is holding a meeting in London on Wednesday 14th April, 12.30 til 4pm for Counsellors and Psychotherapists, at 35 King Street, WC2E 8JG. Their key-note speaker is none other than the HPC Director of Policy and Standards Michael Guthrie! UKCP Chair Andrew Samuels has written to insist that the Union present a balanced case, he has been offered a place at the table.

The tension between small local actions and the leverage gained from organisational cohesion is central to this struggle. But so too is attention to the power of small strategic committees. One commentator, notes the power of the quiet work of the Merits of Statutory Instruments Committee, whose labours she has been monitoring for the last two years.

This committee, buried in the labyrinths of Parliament, published the results of its recent research (A study of post implementation reviews of secondary legislation) at the end of January this year. They have been most concerned about, well, the merits of SI that government increasingly like to use. This is a quote from their conclusion: “The NAO [National Audit Office] conducted a benchmarking study for us: it found that 46% of the sampled SIs with Impact Assessments from 2005 had not been subject to any evaluation of their effectiveness after 4 years, and only 29% had received a full post-implementation review.”

The secretary to this committee has been most courteous and helpful to those of us who wrote in to raise our concerns when the draft Section 60 order (to hand over the psychologists to the HPC) was going through parliament last summer. She also wrote to me recently to confirm that the committee is very aware of the concerns our profession has about the impending HPC regulation. She invited us to get in touch when and if the S60 enters parliament later in the year:

“The Committee is very aware of the stakeholders' concerns over the regulation of psychologists and therapists. Currently it has no scope to influence the development of the legislation, our remit only runs once the final version of the instrument has been laid before Parliament. However as soon as the 2nd Order is laid, if it is laid, the Committee will be very interested to hear your views on the proposals.” (email, 1 Feb).

A colleague has pointed out that the research undertaken by the MoSIC has resulted in a new strategy of action for them and thinks it is this that is the real coup against HPC’s intention to blunder on with the S60.

The report’s main recommendations are:

* Government should take a more active role in supervising both Impact Assessment (IA) and Post-implementation Review(PIR) systems to ensure that the approach is appropriate and the reviews are done. The formats for both should be more closely aligned in terms of content and method.
* Departments should ensure that all IAs include a clear statement of the baseline position against which the change introduced by the legislation can later be measured to assess whether the success criteria have been met.
* Departments should propose arrangements for PIR in the consultation exercise on the draft regulations that are appropriate and proportionate to the content of the regulations. This applies just as much to public sector legislation as to that which affects business.
* All PIRs/evaluations on Statutory Instruments should be published online, alongside the original IA.
* Each Department should establish and maintain an online register of its legislative portfolio to track PIR commitments, aid consolidation, and also to smooth transition when machinery of government changes are made.”
http://www.parliament.uk/parliamentary_committees/merits.cfm

This suggests the MoSIC will not allow any future SI to proceed on its journey through parliament, UNLESS AND UNTIL IT PROVIDES STRONG BASELINE EVIDENCE against which it can then measure an improvement as a consequence of its passage into legislation. That is, unless it is clear what harm already exists, the SI cannot hope to persuade anyone that it will improve the situation. It is now necessary for any government to prove that there is harm of a significant level before it wades in and tries to cure that harm with a SI. If the MoSIC does indeed possess the power to prevent a draft S60 from entering the parliamentary process, then this could also be why the DH has stopped its drafting.

On this theme it is also worth noting that the Alliance wrote directly to Anne Milton (Conservative) and Normal Lamb (Lib Dem) to ask what their policy will be re regulating counselling and psychotherapy in the up-coming election. Tho still awaiting reply from Milton, a response arrived from Norman Lamb’s office within the hour. It said that the Lib Dem position is to support the introduction of statutory regulation (Lord Alderdice must influence this), but to also understand that concerns are loudly expressed in this field. The reply went on to say that regulation should not be used as an excuse to exclude people from practicing legally if there is no evidence that their methods are harmful (email of 2 Feb 10).

By the way, UKIP is opposed to the Government’s intention to regulate counselling and
psychotherapy through the Health Professions Council. It says their proposals are unnecessary,
costly and impossible to enforce properly. Check their manifesto: http://www.ukip.org/media/policies/UKIPhealth.pdf

So, the hard work of the many people beavering away in their various ways seems to have actually managed to bring the headless machine back under some kind of thoughtful control, tho the JR seems to be the biggest spanner in the works, the one that Marc Seale actually has to take account of. The animosity of those still hoping to gain access HPC machinery still has to be encountered and dissipated. We can expect trouble, but also keep on keeping on. And in the meantime, here’s something nice to look forward to:

Friday 9th April, 2.45 for a 3pm start (ends approx 4.30pm) - a special reading of the new play THERAPY about the clash between the values of psychotherapy and those of the Health Professions Council. 'Therapy' is written by Josh Appignanesi (whose new film 'The Infidel' opens in April) and directed by Matthew Lloyd, whose recent production of 'Duet for One' at the Almeida was highly acclaimed. A hilarious satire, drawing on a detailed knowledge of the current debates while at the same time being accessible to those from outside our field. Richard Schiff from 'The West Wing', will play the therapist. Expect terrific actors, and reserve your seats as soon as possible. The reading will take place at the Vaudeville Theatre, 404 The Strand, London, and the proceeds will go towards the JR Fighting Fund. Tickets are £20 and can be reserved by phoning 0845 838 0829

Template letter for your MP: News of Judicial Review of HPC

[Below is a text you might use to write to your MP, and perhaps the other election candidates, to let them know the issues. It has been prepared by the organisations connected to the JR process]

I think you will be interested to read this update on the judicial review of HPC's process regarding the proposed regulation of therapists and counsellors.

The judicial review of HPC is now in its first stage. Documents prepared by Dinah Rose QC and John Halford of Bindmans have been sent to the High Court which point to problems with the HPC's actions to date. It had been charged with assessing the regulatory needs of counselling and psychotherapy and whether its own system was capable of accommodating this field, yet proceeded as if this was a foregone conclusion. Despite stating several times unequivocally that it had not made any attempt to study these questions, HPC could then write to the Department of Health in December 2009 claiming that it had in fact done so. Attempts to query this contradiction proved fruitless.

The JR papers discuss and document this, as well as other major failures in the process, which indicate that the HPC did not approach its work in a rational or fair way. Alternative models of regulation were not given proper consideration despite being repeatedly brought to HPC's attention. Key questions about the nature of the talking therapies were ignored, and hardly any of the HPC's criteria for regulating professions, such as homogeneity of knowledge base or practice, are applicable to our highly diverse field.

The first set of documents will now be scrutinised by the courts. The instructing organisations are The Association for Group and Individual Psychotherapy, The Association of Independent Psychotherapists, The Centre for Freudian Analysis and Research, The College of Psychoanalysts-UK, The Guild of Psychotherapists and The Philadelphia Association. Funding of the review has been made possible by contributions from thousands of therapists and members of the public who feel strongly about the issue.

Significantly, the Department of Health has now said that it has "taken no view of the legality of the decision and recommendations [of HPC ] and will await the Administrative Court's decision on the claim. In the meantime the Department intends to continue work in relation to assessing the costs and benefits of different models of regulation for psychotherapists and counsellors". This is an important statement, as until now the DoH has simply repeated that it will regulate the talking therapies via HPC, and the HPC itself has refused to discuss different models of regulation. The fact that other models are being studied is real progress, and we hope that the DoH will work with our organisations and examine the models used in other countries, where regulatory arrangements have been arrived at that are satisfactory to both government and the field itself.



Problems with HPC


Since the 2007 White Paper '`Trust, Assurance and Saftey', the Department of Health has given the Health Professions Council the task of assessing the regulatory needs of the talking therapies and its own suitability to regulate them. This brief, however, was understood as an imperative to regulate, with a resultant neglect of representations from the field and no questioning of the suitability of its own regulatory framework.

The Health Professions Order states that any profession to be regulated by HPC “must cover a discrete area of activity displaying some homogeneity”. Counselling and psychotherapy constitute a diverse field and display little homogeneity. Many therapies do not consider themselves or advertise themselves as health professions. They focus on human relationships and not medical-style interventions with set outcomes or promises of cure. Unlike health professions, many therapies do not aim at removal of symptoms, but at an exploration of human life, understood in a variety of ways.

HPC has claimed recently that it is able to encompass relationship-based work, pointing to its apparently successful regulation of psychologists and arts therapists, yet there are very significant differences between these fields and our own, and there are many psychologists and arts therapists who feel that their work has already been compromised by HPC. Crucial to our work is the way in which elements from early life may be re-enacted in the therapy, and the long process of exploring this is generally not shared by these other fields.

The consultation process initiated by the Department of Health was intended to assess the feasibility and suitability of state regulation through dialogue with all of the professional field. However, the consultation process became monopolised by a small number of people with a narrow view of talking therapy. This reliance on a small number of people with a set agenda has created the illusion that counselling and psychotherapy are a homogenous field. It has also meant the wholesale exclusion of professional groups and user groups, despite initial inclusion in draft documents.

The key issue in the regulation debate has been protection of the public. Therapists accept that their clients need the highest possible form of protection from inadequate and unethical practitioners. No therapy organization or individual has argued against this principle. Indeed, therapists have consistently been open and active to strengthen the effectiveness of their current systems by all reasonable means. However, there is no research based evidence suggesting that the client-group here is in the degree of danger that would justify being forced into a type of regulation that, in many respects, is unsuitable and unworkable for current professional practices.

HPC complaints procedures are formal and adversarial. Most complaints in the field of the talking therapies are resolved by informal process and mediation. HPC gives no place to these processes, and thereby risks alienating potential complainants who do not wish to enter into such formal procedures, held in public with none of the confidentiality that a hearing may require. It also lacks the expertise to deal with the complexity of complaints in this field. Note that HPC reject more than 70% of complaints from the public as 'no case to answer' compared to around 10% in the main therapy organisations. As HPC states on its website, if they don't think a complaint will have a clear outcome, they won't hear the case, in contrast to the acceptance of complex complaints by therapy organisations.

HPC focus on two central issues regarding protection of the public: that any unscrupulous individual may set up a brass plate advertising their services as a therapist, and that, once struck off by a professional body, a therapist can simply continue to practise independently. Yet neither of these concerns is addressed by HPC regulation. HPC regulate professional titles not functions, so as long as the individual does not use a title protected by HPC, they can set up shop through use of any unprotected title: life coach, mentor, therapist, lifestyle consultant etc. Other models of regulation used abroad are much more effective, yet to date HPC have refused to examine them.

The HPC brings with it mechanisms that may be suitable for professions allied to medicine, but which threaten the survival of the very essence of psychotherapy. Therapy is forced into a one-size-fits-all model of healthcare intervention, with its focus on outcomes and protocol-based procedures. By marginalizing and even making illegal those forms of therapy which follow a different model, HPC regulation would deprive the public of their free choice of which therapists to consult.



The Regulation Debate



The field of counselling and psychotherapy in the UK is rich and diverse, with several hundred different schools and orientations. Approaches to therapy differ enormously: some therapies focus on symptom-relief, some specifically avoid this; some aim at insight into unconscious phantasies, some reject the very notion of an unconscious; some try to bolster a patient’s belief-system, some to undermine it; some encourage physical warmth, some proscribe this; some aim to get patients back to work, some do not. The range of practices is extraordinarily wide, and the public benefits from a choice as to this range of different approaches.

Since the early 1970s, the field has organized itself into a small number of umbrella organizations - UKCP, BACP, BPC - which have worked progressively on codes of ethics, practice and complaints procedures. There have been various attempts over the years to add a statutory framework to the field’s own set of procedures, yet these have been consistently ignored or rejected by government. Nearly every practitioner currently working in the UK belongs to a professional association with codes of ethics, practice and complaints procedures, which is inspected periodically by its umbrella organization. These codes were found by the UKCP-BACP mapping project, funded by the Department of Health, to fulfill or exceed HPC requirements.

This situation has not been especially controversial, yet calls for statutory regulation have been made by some therapists and lay people for the following reasons: there is nothing to stop any untrained person setting up a brass plate calling themselves a therapist; if a therapist is expelled from their professional organisation, there is nothing to stop them continuing to practice elsewhere; there are a small number of therapists who do not belong to any organisation and so are not subject to any agreed codes of ethics, practice and complaints procedures. These three factors are deemed to represent a significant risk to the public, which is the main reason given for statutory regulation.

The scare stories circulated to the media by HPC and by Witness, an advocacy group that the HPC has worked closely with and that is largely funded by the DoH, serve to inflate the risks involved and confuse the relevant issues. No therapy organization in the UK to date has shown any opposition to regulation. The question for them is whether HPC regulation is the best way to deal with these issues of protection of the public. HPC regulates professional titles, so if it regulated the title ‘psychotherapist’, it would be illegal for anyone to use this title without being HPC-registered. Likewise, being struck off the HPC register would make it illegal for someone to continue to offer services as a psychotherapist. This seems to solve the issue of public protection, yet HPC regulation in fact fails to do so since the practitioner may simply set up shop using another title not regulated by HPC: life coach, therapist, life skills advisor, mentor etc. It thus fails to deal with the brass plate argument or the practicing after expulsion issue.

Even if it were to close these loopholes by regulating functions and not simply titles, HPC regulation poses a number of very serious problems to the field of the talking therapies. It subscribes to outcome-based notions of health and wellbeing which are rejected by many schools of therapy, as well as redefining the actual concept of therapy itself. Therapy is defined as the correction of developmental and psychological dysfunction via the application of a set of techniques to the patient. Yet many schools of therapy see their work as totally opposed to this model based on the health/illness framework. For them, therapy is a joint work, a collaborative effort to explore human life, with no manifest aims to ‘correct’ dysfunction or promote health.

The very notions of health, wellbeing, normality and dysfunction are rejected by many schools of therapy. These schools of therapy have a tradition of social critique, and distance themselves from the contemporary industry of ‘wellbeing’. Terms like ‘health’ and ‘wellbeing’, they argue, often carry a political agenda in any given society, and the work of therapy has to go beyond them. Psychoanalysis, for example, has always aimed to subvert received forms of knowledge, and hence the current objection from most of the UK’s psychoanalytic groups to subsume analysis into a framework which is based on received forms of knowledge and power.

Given that the notions of health, wellbeing and illness run through HPC regulations, and influence its requirements regarding education and training, conduct, performance and the hearing of complaints, they naturally see HPC as unsuited to regulate their work. To construe therapy as a set of techniques to be applied to a patient, rather than as a relationship, an ongoing work between two people which can have no predictable outcomes or set goals, is to misunderstand its basic principles and ethics. HPC has redefined therapy though a medical lens which is not appropriate to the relationship-based paradigm of analysis and many therapies.

HPC uses a model of health professions as service industries: a client pays an expert for a service, which they deliver. But for many schools of therapy, the service is actually provided by the patient. Like an artist’s studio, the therapist provides a space where the patient can create something, following their own rhythm and logic. Therapy is thus not about the performance of any procedure. No outcome can be predicted in advance and so, contrary to the service industries, it is not self-evident what product the patient is paying for. This inherently risky work is clearly not served by pretending that its results and procedures are clear, predictable and transparent.

So where medical interventions may involve set outcomes which the patient could complain about if not achieved, many therapies are about the open-ended work done not by the therapist but by the patient. One could visit a therapist’s office for years and not actually be doing a therapy, in the sense of being authentically engaged in an activity of self-exploration. Therapy, for many schools, is about what the patient manages to invent and construct in their encounters with the therapist, who does not apply the kind of protocol-based procedure envisaged by HPC.

Likewise, some schools of analysis and therapy hold that patterns of thought and behaviour that produce suffering in the patient derive from childhood responses to what is unknown and unpredictable in their caregivers. The compulsion to please others, for example, may have its roots in interactions with an erratic and unpredictable parent. Therapy will play out this situation, so that the therapist may behave in an erratic and unpredictable way, allowing an access to the process by which the patient’ patterns of response were established. HPC’s emphasis on clarity of communication and behaviour may fit a small group of therapies, but cannot subsume this latter model.

Many clinicians who do not subscribe to the healthcare model see their work as an exploration of the human condition, a journey in the same sense that becoming a Buddhist monk involves a long process of questioning one's life, ideals and expectations. Like a Buddhist training, this long process of psychotherapy cannot be identified with a set of techniques or procedures to be applied to a human being, but forms rather a strange kind of relationship which operates in unpredictable and unexpected ways. One cannot know what will happen in advance, and change often takes place through surprise, bafflement, shock and disappointment. HPC regulates professions within a framework which explicitly aims to remove these variables, and so it cannot accommodate those therapies which give a valued and central place to risk, shock and disappointment, seen as tools of growth and development. With HPC, will therapists really continue to challenge their patients or, fearing complaint, will they little by little change the way that they work?

A further and critical reason for the unsuitability of HPC as regulator lies in the field of ethics. Psychotherapy has, for the last 100 years, offered the patient a system of values freed from the moral judgments of social authorities. This has indisputably been the central characteristic of psychotherapy and what set it aside from the mental hygiene movement and from techniques of social engineering. Therapy provides a space for challenging received wisdom, social imperatives and norms of all kinds. Yet HPC regulation, for many schools of therapy, would involve the wholesale application of such norms to the therapeutic encounter. The therapist would have to become a ‘health professional’, whose practice must adhere to a moralistic and normative framework. Failing this, the practitioner would be struck off.

This tension between psychotherapeutic ethics and social morals is a crucial issue, yet it must not be misunderstood to suggest that therapists see their work as somehow beyond the law. All therapy organisations agree that rigorous codes of ethics and conduct must be in place, as well as complaints procedures. In the event of any instance of sexual assault or financial fraud, the criminal justice system should be appealed to. In line with international practice, in other cases, mediation and informal resolution of complaints are the first step, rather than automatic escalation of a complaint to the level of litigation.

For some critics of traditional models of regulation, mediation and informal resolution are a profession’s way of avoiding responsibility for mistakes and misconduct. Yet escalation to the level of litigation and formal complaint may constitute barriers to real resolution of issues for those working within a non-healthcare model. For those therapies that are relationship-based, the parallel is less with HPC-regulated disciplines such as radiology or physiotherapy than with the introduction, encouraged by government, of mediation procedures as a first step when the divorce of a married couple is considered. Although this might seem surprising, it reflects more accurately the kind of problems some patients may experience in therapy - which, for many schools, is about re-living problematic relationships from the past – than the model of a failed medical intervention.

Yours sincerely

Guest post by Bruce Scott on the FTP hearing of Malcolm Cross

A case of dialectical disease: A tale of a Health Professions Council fitness to practice hearing of a psychologist.

Bruce Scott
Philadelphia Association, London

Whilst attending the Health Professionals Council fitness to practice hearing of Dr. Malcolm Cross on the 15th and 16th of March 2010, a conversation came to mind that took place between the playwright and poet Goethe and the philosopher Hegel in 1827. Their conversation highlighted the problem of “dialectical disease” of what this hearing, I felt, was suffering from. The conversation between Goethe and Hegel went as follows:

The discourse then turned upon the nature of dialectics. “They are in fact” said Hegel, “nothing more than the regulated, methodically-cultivated spirit of contradiction which is innate in all men, and which shows itself great as a talent in the distinction between the true and the false.”
“Let us only hope,” interposed Goethe, “that these intellectual arts and dexterities are not frequently misused, and employed to make the false true and the true false.”
“That certainly happens,” said Hegel; “but only with people who are mentally diseased.”
“I therefore congratulate myself,” said Goethe, “upon the study of nature which preserves me from such a disease……I am also certain that many a dialectic disease would find a wholesome remedy in the study of nature.”

It became clear during the course of the hearing that it was afflicted with this “dialectical disease” as they (i.e. lawyers, judging panel, complainants etc) were focussing upon and arguing about the notion of what amounts to “misconduct”. In effect they were trying to make the false true and the true false in their logical argumentations of what constitutes misconduct. As I sat in stunned silence, a fear came over me. I felt unsafe amongst these diseased dialecticians as the concerned parties , for what appeal to reason, or to nature as Goethe advocated, would or could be heard? Human nature had been left aside, human freedom had been forgotten, and common sense had been replaced by an authoritarian pseudo-psychological medico-empirical scientific dialectic pertaining to the notion of misconduct that was divorced from any “alternative” or freer way of looking at misconduct (if it could be called that). This lead to an abusive and violent hearing and sad conclusion to the hearing. Let me explain why.

The facts of the case have recently been circulating within various media (i.e., newspaper reports), but let me summarise . Dr Cross was the Chair of an accreditation team (4 in total) visiting a university to carry out its evaluation of a university counselling psychology course to see whether it was up to the job of being accredited with British Psychological Society (BPS) validation. The team met the night before at a hotel and had a brief discussion about the paperwork and any issues pertaining to the accreditation visit. Dr Cross felt (as Chair of this team) that there was very little to go over and that everything was in place for the visit the next day. Then team then went for dinner to a restaurant along with the wife of one of the team members. At dinner wine was drunk (4 bottles in total) and everybody was drinking. Dr Cross was not working as a psychologist at this dinner; neither were any other of the team in their respective roles. It was purely a social occasion. I will relate the facts of what happened during this meal in a moment, but suffice to say, Dr. Cross carried out his duties the next day as the head of the accreditation team perfectly well. Indeed, all the members of the team, which included the two complainants against him, described his performance the next day as “exemplary”. So one might ask what was the problem that occurred the evening before?
During the course of the dinner (and short informal meeting before dinner) Dr Cross was accused of:

1) Being drunk (at the dinner and when he arrived at the hotel for the informal accreditation discussion).
2) Being rude, lewd and condescending during the course of the evening.
3) Touching himself in a sexual manner.
4) Making sexual gestures to two of his colleagues: trying to kiss, express his love and offer oral sex to one colleague and touching the leg of another.

Some people may jump to the conclusion that these events are indeed misconduct and in need of judicial/HPC treatment. Such people might shout, “What! A psychologist drunk, rude, condescending and being sexually disinhibited! What scandal, strike him off, take him to the gallows!” Well obviously some people did, and it went through the laborious administrative process at the HPC and thence to hearing.

Here is an extract from a clinical psychology internet forum from a blogger after I had alerted their attention to the case of Dr Cross and the nature of HPC hearings . This blogger’s comments highlight the pervasiveness of diseased dialectical processes in the pro-HPC camp. It clearly does not see everything as it is in the clearing to quote Heidegger .

“….it would be highly concerning to me that such behaviour might have an impact on the people they work with, and beyond a certain threshold it would be appropriate to make a complaint. After all, a complaint is then investigated and a hearing is held, where parties can appoint solicitors, in which the person can challenge the allegations, and other witnesses can be called, and their peers can comment on their behaviour and what is outside of acceptable limits.”

Well, that makes it all ok then! Bring on the trial, justice will be done, the law will prevail – or does it?

The HPC lawyer cross-examining Dr Cross obviously believed in such a process. In her summing up of the case she brought the hearings attention to point 3 of “the Standards of conduct, performance and ethics” of an HPC registrant. This states:

“You must keep high standards of personal conduct, as well as professional conduct. You should be aware that poor conduct outside of your professional life may still affect someone’s confidence in you and the profession.”

Following on from this, point 4 on the Standards of conduct, performance and ethics states:

“You must tell us (and any other relevant regulators) if you have important information about your conduct or competence, or about any other registrants and health professionals you work with.”

The HPC lawyer then went on to argue that one has to consider the wider public policy (i.e., protection of the public). She argued that Dr. Cross’s behaviour was evidence of misconduct and was of interest to the confidence and safety of the public as he is a psychologist and treats vulnerable people. Concluding, she argued that the alleged misconduct of Dr Cross is evidence of his impairment of his fitness to practice. She referred to a case brought to the attention of the General Medical Council a few years ago where a Doctor had crossed the boundaries of the patient-doctor relationship (the Doctor had sex with his patient which was consensual). When I heard her mention this case I thought to myself what relevance is this to Dr Cross’ case.

These assertions of misconduct were bolstered earlier in the hearing by the fact that one the complainants (a psychologist) argued, whilst on the stand giving evidence, that Dr Cross’s behaviour was indicative of a potential serious problem that needed to be addressed. Don’t forget, this complainant had also been drinking on this evening. He confessed to drinking three glasses of wine. Perhaps it was more, maybe 4, or 5 perhaps. The second complainant (a British Psychological Society secretary whose role it was to takes minutes during the accreditation meeting the next day) was, according to the testimony of all others who gave evidence, texting, twittering, or emailing on her mobile or blackberry throughout the dinner. She accused Dr Cross of being rude to her and belittling her. She said he was nicer to everybody else compared to her. Dr. Cross had said to her that if she missed her friends that much, she should have stayed at home. Doesn’t the new DSM manual have a new disorder called something along the lines of “internet addiction” which leads to difficulty in social interactions and interpretation of social cues and interaction?

My mention of binge drinking and internet addiction is said with tongue in cheek. I was quite surprised that the HPC panel, the HPC lawyer, and Dr. Cross’s lawyer did not bring these facts up for any real discussion. However, the lay member of the panel did mention that she would find such “twittering” behaviour very rude.

Yes, Dr, Cross did admit to trying to kiss one of the accreditation team, told him he loved him and offered to give him oral sex. But he did say it was a joke, a bad joke perhaps, and not well received by one member of the team. The other male member of the team in his statement to the hearing (a paper submission) reported that he just laughed at Dr. Cross’ disinhibited sexual jokes and antics and did not think they were serious, and he was not offended by them in any way and neither was his wife who was also present.

So, the panel adjourned on the second day at around 11.15am to see if Dr Cross’s behaviour amounted to misconduct of an HPC registered psychologist and if it amounted to an impairment of his fitness to practice. I had to wait for 6 hours to be called back for the result.

Luckily for Dr Cross, although the panel thought that he was drunk, lewd, and rude, it was not proven if he touched himself in a sexual manner (evidence submitted showed that the complainants could not see this occur as he was sitting in such a way that he was obscured). It was also not proven that Dr Cross was serious in his gestures of love and affection to people at this social occasion. The panel ruled that his behaviour did not amount to misconduct and thus the allegation of misconduct was not well founded. “Justice was done!” the pro-regulation brigade might shout at such a result. “You see,” they might say, “it is a good process, everything was done above board, witnesses were called, and he was cleared.”

Was he cleared? Is Dr Cross in the clear? Not according to the newspapers. He was written about as though he was guilty. The story was sensationalised with all the lewd bits highlighted to the omission of more balancing facts; that two other people were present at the dinner and they thought Dr. Cross’s behaviour was fine; disinhibited, joking, and fun yes, misconduct, no. It was not reported that nobody left the dinner and walked out in disgust; everybody enjoyed a two-course dinner with wine. It was not reported that everybody was drinking, and that no restaurant staff or diners made a complaint about Dr Cross. It was not reported that the BPS, who had been initially consulted about this incident by one of the complainants, wanted to deal with the incident in house. But this complainant was not satisfied with this; it was subsequently taken to the HPC. A grudge perhaps? More importantly, it was never reported in any of the newspaper reports that Cross was not on duty as a psychologist at the time, and also that he carried out his duties in an exemplary fashion (to everybody’s testimonies given) the next day.

What was most upsetting to me just when the HPC panel finished delivering their verdict, Dr Cross broke down into tears, and rushed out of the hearing room. Nobody flinched. I was almost brought to tears myself witnessing this. It was terrible. Dr Cross had been brought to trial, and I call it trial because it had all the hallmarks of a legal trial, and his reputation has been “sullied” by the press and his colleagues and the HPC process in a most disgusting way. This will no doubt affect his working life and livelihood and perhaps even his personal life and relationships. But never mind, justice was done, he was cleared. Of course, I am being ironic in this last statement.

I think at this juncture it might helpful to again look at this idea of “misconduct”. Dictionary definitions of misconduct pertain to: behaviour not conforming to prevailing standards of law, bad management by persons entrusted or engaged on another’s behalf, and deliberate wrongdoing, especially by government officials or military officials. The thesaurus, just for interest, gives some unsurprising results: to behave oneself improperly, rude behaviour, horseplay, and naughtiness.

There are also legal definitions of misconduct. These pertain to ideas of wrongful, improper or unlawful conduct motivated by premeditated or intentional purpose or by obstinate indifference to the consequences of one’s acts.

There are many other definitions of misconduct, but to draw the reader’s attention to these most common and helpful one’s presented here and re-direct the reader above to the HPC standards of conduct, performance and ethics (points 3 and 4), it is clear there is a huge scope for the application of misconduct that the HPC can pursue. Therefore it is clear from this that the HPC has become a dangerous monster. It is quite clear, that in their use of their idea of what constitutes misconduct, the HPC have in effect committed misconduct (mismanaged) themselves in the case of Dr Cross.

Why do I charge the HPC with misconduct in the case of Dr Cross and in general of becoming a dangerous institutional monster? Taking into consideration the scope of what misconduct can cover, and also how the HPC standards of conduct, performance and ethics are laid out, their system is open to abuse, as has occurred in the case of Dr Cross, by the HPC, registrants and patients or the general public. Points 3 and 4 of this document covers personal conduct but also the proviso that a “registrant must tell us (and any other regulators) if you have important information about your conduct or competence, or about other registrants and health professionals you work with.”

This framework encourages denouncements by colleagues and negates the possibility of talking to colleagues about problems, encourages defensive personal and professional conduct, and promotes a lack of trust in oneself or the possibility of efficient self-reflection. I think this is what Michel Foucault calls the panoptic society whereby, we overly self-govern ourselves out of fear of being caught out by the surveillance of the institution that makes the rules.

The HPC has however has wildly distorted any ordinary self-governance so that people denounce their colleagues to those who pretend to be the guardians of the public. In other words, we cannot act freely because the “Big Other” as Zizek explains, is always in the background, haunting our being, and robbing us of our ontological freedom. The HPC mistake themselves for the “Big Other”, in a Big Brother Orwellian way. Others are watching our behaviour for any flaws and will report this, not to us, but to the HPC. But we even have to watch out for our own flaws, and must report ourselves to the HPC if we notice any in ourselves. Has the HPC panoptic machine not gone too far?

It is clear from the HPC’s framework, that anybody who is offended by somebody’s (e.g., a psychologist) conduct such as swearing, smoking too much, not sleeping properly, being unfaithful, driving too fast, being late for work, eating unhealthy foods, spending too much time shopping or watching too much television, could make a complaint to the HPC. The examples I list could all be classed as misconduct. But please note, it also depends on who is offended. Some might be offended by such behaviour, others not. This is what occurred in the case of Dr Cross; some people were offended, or perhaps frightened by their duty to the HPC panoptic machine. Or was it because that they felt he didn’t like them as much as they thought or wanted him to like them?

What I am trying to say is this; was there not a better way to do things in the case of Dr. Cross and does the HPC not realise (maybe it does) that their dialectic concerning misconduct has reached monstrous proportions? I put it to the HPC that they have breached their own codes of what amounts to misconduct. They have badly mismanaged their position; protection of the public, and brought a case to hearing that had already been dealt with by the British Psychological Society. This case could have been dealt with (by the BPS for example) in a much more humane, civil, and satisfactory manner). Instead, they have infantilised a profession (psychologists) by encouraging them to snitch on colleagues for matters that previously could be dealt with face-to-face or in-house at work. In the past one could actually talk to a colleague or have word with your manager if someone offends you or if you are concerned about someone’s behaviour. But it seems that such simple gestures seem to be regarded by pro-HPC persons and bodies as obsolete and unreliable; we cannot be trusted anymore! God forbid the HPC cry, stop people from negotiating personal and professional relationships by talking to each other. Dr Cross has been dragged through the papers and his reputation sullied by offending two people. Dr Cross is a member of the public and has not been protected by this shambolic process. The HPC’s fitness to practice is impaired as they have damaged a psychologist’s career and livelihood (and perhaps eroded what it means to be human and the freedom of what this entails) whilst disregarding their ridiculous standards of conduct, performance and ethics of how they deal with misconduct.

We do unfortunately live in world where we will at some point offend someone. We will get up peoples noses and have disagreements. We will all also live lives and engage in behaviours that others will feel are unhealthy, dangerous, and in need of change; we all will. So the sorry state of affairs we all have to accept is that all psychologists, psychotherapists, and counsellors will at some point break the HPC standards of conduct, performance and ethics, and so will the HPC. Let’s all hand ourselves in and get it over and done with! The rock solid idealism of the HPC and how an HPC registrant should be is a fairytale and represents a quite frightening delusional fantasy of what the world should be like. The way the HPC lawyer and two complainants spoke about misconduct painted a picture of reality where no risk, fallibility, or pain (psychic) should enter human life or behaviour. This is dialectical disease.

We live in a world where there are unjust wars being waged (by our own and other governments), there is the banking crisis which exacerbates the greed and deceit by the bankers, politicians are fiddling their expenses and engaging in dodgy lobbying for private companies which affects government policy. The gap between rich and poor is bigger than ever, and there are thousands of homeless people roaming the streets of our country who do not have a warm bed to sleep in or hot plate of food to eat. Thus, I ask, why is it that health professionals (and psychotherapists and counsellors) are being targeted by such a massive projection or demand for “safety” (by the HPC and society in general). I feel we should take Lacan’s lead and seriously look into this demand and see what it has to say. I think underlying this demand may be something quite sinister or at least, fraught with dis-ease. However, I think we have right to feel ill at ease in today’s times, but I feel it is a cheap shot to target health professionals (and psychotherapists and counsellors) . The last thing we need, considering the state of the world today, is a panoptic state breathing down our necks accompanied by a diseased dialectic of what it means to be human or a psychologist (in his or her personal life). The HPC and similar constrictive institutions seem to want to impose a world view where no risk ever takes place, where human beings conduct themselves like robots and are rewarded for perfect behaviour, but severely punished for straying from the (ur) model.

I wonder what Goethe would have thought if he had witnessed the HPC hearing of Dr Malcolm Cross? I am certain that he would have felt that HPC’s dialectical disease would find a wholesome remedy in the study of the nature of the situation, instead of a dialectical process of trying to make the true false, and the false true, which is what occurred on the 15th and 16th of March 2010 in Kennington, London.


Footnotes
i Conversations of Goethe, with Johann Peter Eckerman. Da Capo Press (1998). Extract taken from page 244.
ii The HPC lawyer, Dr. Cross’s lawyer, the “independent judging panel, and witnesses including Dr. Cross.
iii There is no record of the case or the result of Dr. Cross on the HPC website for the public to consult. I have been in touch with the fitness to practice hearing department at the HPC and they told me that as this case was “not well founded” it automatically becomes deleted from the past hearings list. However, if Dr. Cross wished his hearing details and result to be left on the list (for whatever reason), it would be left on. However, other similar cases’ details and results have been left on the list. It remains to be seen if the HPC have “erased” the case of Dr Cross Orwellian style, for fear of what this terrible, abusive, and highly mismanaged case might signify to a public critical of the HPC regulation of psychologists, psychotherapists, and counsellors.
iv www.clinpsy.org.uk
v Martin Heidegger. Zollicon seminars: Protocols-conversations-letters. Published by Northwestern University Press in 2001.
vi Michel Foucault. Psychiatric power: Lectures at the College de France, 1973-1974. Published by Palgrave Macmillan in 2006.
vii Slavoj Zizek. How to read Lacan. Published by Granata Publications in 2006.
viii Jacques Lacan. Ecrits. A selection. Published by WW. Norton & Company in 2002.
ix I do not subscribe to the view that psychotherapists or counsellors are health professionals.

New Play - THERAPY, by Josh Appignanesi (Fund raiser for the Judicial Review of HPC)

9 April, 3pm - a rehearsed reading of the new play about the clash between the values of psychotherapy and those of the Health Professions Council.

'Therapy' is written by Josh Appignanesi (whose new film 'The Infidel' opens in April) and directed by Matthew Lloyd, whose recent production of 'Duet for One' at the Almeida was highly acclaimed.

A hilarious satire, drawing on a detailed knowledge of the current debates while at the same time being accessible to those from outside our field. Richard Schiff from 'The West Wing' will play the anti-HPC therapist, and the rest of the casting is being done now.

Expect terrific actors, and reserve your seats as soon as possible. The reading will take place at the Vaudeville Theatre, 404 The Strand, London, and the proceeds will go towards the JR Fighting Fund.

Tickets are £20 and can be reserved by phoning 0845 838 0829

I just had occasion to revisit this letter, sent to my MP last year. Plus ca change...


18 February 2009


Rt. Hon. Tessa Jowell MP
House of Commons
Westminster
London
SW1A 0AA

Dear Tessa Jowell

I came to West Norwood library towards the end of last year to see you, and spoke to one of your very helpful and friendly staff. The upshot of that meeting was that I would write you a follow up letter (in addition to the one I wrote earlier in that year). At last, this is that letter.

I have created a blog: HPCwatchdog.blogspot.com based on a whole series of visits I have been making to the HPC as a member of the public. If you read the case of Mr R (part 1, part 2, part 3), watch the video of Richard Gombrich explaining Popper's Nightmare, and consider the questions raised by Max Weber, this will give you a quick insight into my concerns and my orientation.

I am very worried indeed about the centralisation of power and the destruction of local knowledge that is the unintended consequence of the kind of regulation that is practiced by the HPC. From what I have seen it is already causing harm to ordinary decent people, and I truly believe that this harm has a pernicious quality that will be exponentially increased if the HPC draw the psychological practices within its domain.

Onora O'Neil has publicly voiced her concern about the destruction of trust that will follow the state regulation of psychological practices (especially of psychotherapy and counselling, but the psychologists are also very much in this domain). Michael Power has been writing about the way our audit culture ends up emptying the meaning out of words and practices, and leave us vulnerable to the collapse of the resulting empty shells, and Marilyn Strathern has also pointed to the hostile and aggressive undercurrents at play in moves under the banner of transparency. Aggressivity will increase where real meaning decreases – this is a lesson learned many times over throughout history.

Each of these great British scholars has been working away quietly revealing the otherwise hidden 'mechanisms' that hold our society together. None of them pretends to have the answer, nor the whole truth, but each of them is shedding very helpful light in very careful ways on things that we need to be very aware of.

I don't believe there is one answer to the situation we are currently in, but I am trying to find a way of approaching the questions without fueling aggressivity nor unduly increasing levels of anxiety. I suggest that a space be created which makes it possible to think. The rapid expansion of the HPC is not conducive to thinking. When I attended the Investigating Committee meeting last week (blogged on 12 Feb 2009) I was chilled to learn that the Kent Police had been invited in to train staff how to deal with escalating aggression. A much more sensible approach would be to ask why the aggression is escalating. From the hearings I have observed, and from comments I have received as a result of my blog, I can see a very strong argument that the orientation and mechanism of the hpc (the grounds on which it is empowered) actually fuels aggressivity - this creates a spiral which echoes Popper's nightmare and adds to the idea that this is what is being created.

It is difficult to know how to intervene, but I very strongly believe that we need to slow the process down, and give ourselves more time to think. How can I help to postpone the process of the Statutory Order that would pass the psychologists onto the HPC register? If you can advise me of this, I would be extremely grateful. If you would like me to explain my ideas in more detail - I am easily contactable. I would be happy to respond to a call and very receptive to any help you can give in shaping a parliamentary question on this issue.

Yours sincerely



Janet Low, MA PhD