How Complaints and Fitness-to-Practice fit into to the government’s scheme

January 26, 2008

Complaints and Fitness-to-Practice are enshrined in the Health Professionals Order 2001 which regulates ‘health professionals’ including psychologists, counsellors, therapists and psychoanalysts. The logic underlying both of them is similar: There is the one standard Health Professional and the one standard treatment for each bundle of symptoms. Thus if you deviate from the One standard you are not fit for purpose.

Complaints: If you peruse the pages of Therapy Today (British Association of Counselling and Psychotherapy) or the pages of The Psychologist (British Psychological Society), or ‘In Focus’ the on-line magazine of the Health Professionals Council, you discover pages of adjudications on user’s complaints. Common complaints are failure to keep notes, inappropriate remarks, failure to attend appointments. None of these complaints are illegal. The government’s allegation is that this failure to apply the one authorised treatment in the prescribed manner causes the user long-term damage. (A large part of medical students examination marks goes on introducing yourself, shaking hands and offering a seat. This is the government’s clinical judgment of what is important for a doctor to do. The BMA are helpless – they have had their power taken from them in all areas except negotiating wage deals. The previous Minister for Health, Andy Haines, declared in November 2006 that the BMA is only the Doctor’s trade union.) This becomes more serious when the government intervenes directly in the relationship between the practitioner and user. It does this by advertising in public places for complaints. If the practitioner is found to have deviated from the One standard, then they are publicly chastised, the modern day equivalent of being put in the stocks. I remind you that all transactions in the field of health are based in relationships. These relationships differ with each coupling: thus my headache is different to yours. It is over 10 years since I consulted my doctor with headaches, hot flushes, etc. The doctor flicked to the correct screen and asked me the required questions. She inputted the answers. The machine prescribed HRT and the prescription was printed. I still have the prescription in one of my ‘filing’ piles. Doctors are now risk-averse which means they are not relationship-based, but implementing government prescribed procedures. Not, of course, all doctors. In a R4 programme ‘Where is the femur?’ on 1st January, 2008 the advice was given not to consult any doctor who is under 35 years old.

I wonder how they work out that failure to implement government defined procedures, taking notes, shaking hands, etc causes long-term damage?

Complaints and criminal acts. Do registration and the control procedures legally defined in registration protect users against criminal acts: murder, rape, and mis-selling as in claiming results or qualifications you do not have.? No. Over 100 years of statutory regulation of doctors proves that. Robert Edyvane’s interesting comment touches on this.

Why does the government believe it does?

The technical answer: They are so wrapped up in their certainty and the delusion that they can provide certainty for the population that counter indications are not seen. I refer you to the story of the Emperor’s New Clothes. This government is driven, not by principles or even agreed policies, (they have abandoned the forum of the annual conference.) but by opinion polls. It wants to retain power so badly, it slavishly does what the paid advisors tell them. (The people who told the Emperor his new outfit was stunning, etc)

The practical answer: It chooses its advisors badly – yes men and women. The government has arrived at NICE clinical guidelines, Improved Access to Psychological Therapies or Happiness Centres and the Health Professions Order 2001 on bad advice. I call these advisors collaborators and implementers of the government’s delusional, perverse systems. They do it for money and prestige. Association with these forms of control systems is very attractive, an aphrodisiac. Let’s name some of them: Lord Alderdyce who is a training analyst within the British Psychoanalytic Association ensured that the title psychoanalyst was included in the HPO2001 so that the BPA could retain control of psychoanalysis in this country. Professor Peter Fonagy, BPA and Freud Memorial Chair of Psychoanalysis, is chair of the government committee implementing competencies. (How do you draw up the One standard competency for a relationship which is unique to each coupling?) Professor Andrew Samuels, Professor of Jungian Psychoanalysis at Essex University, is spokesperson for the United Kingdom Council of Practitioners (UKCP). The UKCP agrees that regulation and registration will protect the public from criminals, charlatans and miscreants and is turning itself into the Government’s lackey in managing very profitably complaints. Happiness Centres (use of NICE guidelines, cbt, on depression and anxiety) are the brain-child of a Professor of Economics from the LSE, Lord Layard. The Savoy agreement made at a conference, end of November 2007, agrees to collaborate with the NICE guidelines and force cbt as the solution to psychical distress. Parties to the Savoy agreement include the British Psychological Society, British Association of Counsellors and Psychotherapists, UKCP, British Council of Psychoanalysts (the front organisation for the British Psychoanalytic Association/ International Psychoanalytic Association), Sainsbury Centre for Mental Health, and so on. The three organisations which are vocal in their opposition: London Society for the New Lacanian School, Association of Lacanian Psychoanalysts, and Independent Practitioners Network through their web-site Ipnosis are fighting this collaborative, perverse system. On a numbers front it does not work. The Savoy agreement organisations represent over 150,000 practitioners whose apathy and obedience to this form of control remind me of concentration guards in the Third Recih. We are small and fighting.

Fitness-to-Practice: This is enshrined in HPO2001. The government’s statutory agency, the Health Professions Council, will decide on acceptable morals for people working in the area of health. Thus, being caught looking at photographs on the internet, even at the level of Pete Townsend, will ensure you loose your job. I remind you that being on the child protection register does not mean you have committed a criminal act. And you will loose your job even if you are working with dead bodies in a pathology lab. The government knows best in the area of morals.

Take the case of psychiatrist Raj Persaud. He works as a psychiatrist. He is also accused of plagiarism in a book he has written. He may be barred (the case is being heard by the BMA) from practicing. I know nothing of Raj Persaud’s practice and I do wonder what the inability to produce original material (this is contested) has to do with working as a psychiatrist. I also wonder what else in the future will make you barred from practicing. Getting a parking ticket, Not paying your train fare, Driving Offences, Protesting at a Planning Application? I do not support criminal behaviour in anyone though I will not be registering with HPO2001 and will therefore become a criminal, myself. There are exceptions to my ruling! However, I refuse this government’s imaginary ideal of what my moral standing should be.

Thank you for reading this.

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