The Law Commission’s consultation on regulation of health and social care professionals: a response: 31st May 2012: Julia Evans

by Julia Evans on May 31, 2012

Contents

1)  The Law Commission’s consultation on regulation of health and social care professionals

2)  Julia Evans’s response to this further CON-sultation

3)  The Law Commission’s acknowledgement of receipt

4)  Circulation list within both Houses of Parliament:  to be updated & the covering note

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1)  The Law Commission’s consultation on regulation of health and social care professionals

From 1st March 2012 to 31st May 2012

 

The consultation:

The consultation paper makes provisional proposals which seek to simplify and modernise the law and establish a streamlined, transparent and responsive system of regulation of health care professionals, and in England only, the regulation of social workers.

The paper makes proposals and asks questions on the following areas:

  • The registration and renewal of registration of professionals, student registers, registration appeals, protected titles and protected functions.
  • How the regulators oversee the quality of pre-registration and post-registration education and training.
  • How the regulators set standards for professional conduct and practice, and ensure ongoing practice standards (for example, through revalidation).
  • The investigation and adjudication of fitness to practise case.
  • The role of the Council for Healthcare Regulatory Excellence
  • The regulation of business premises and activities
  • The governance arrangements of the regulators, including the size and composition of Councils
  • The systems through which the regulators can be held to account, including the roles of the Privy Council, Government and Parliament, and duties to consult the public.

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2)  Julia Evans’s response to this further CON-sultation

To: Mr Tim Spencer-Lane, Law Commission, by e-mail

From: Julia Evans

I am a practicing Lacanian Analyst.

As, is my usual practice, this reply will be circulated within the Houses of Parliament to try and wake them from their stupor over the regulation of provisions for treatments within the area known as Health.

 

31st May 2012

 

Subject:  Reply to the Law Commission’s CON-sultation.

 

My concern which has grown over the last decade or more of engagement with the legislation surrounding the Chief Medical Officer’s ‘high risk health industry’ is that no-one critiques the underpinning of this delusion.

 

It is a legalistic framework built on sand.

 

It is also a centralising mechanism for standards, practices, training, ethics in an area motored by relationships of trust and care.

 

Quote from Professor Lord Norton’s blog ‘Lord Chief Justice on the Public Bodies Bill’ at:  http://lordsoftheblog.net/2010/12/15/lord-chief-justice-on-the-public-bodies-bill/

‘The Lord Chief Justice, Lord Judge, appeared before the Constitution Committee this morning.  It was a very revealing session.  Lord Judge, in a dinner for Her Majesty’s Judges at the Mansion House in July, said that “my deepest concern at the moment is directed to the increased use of what are described as Henry VIII clauses” (i.e. clauses allowing primary legislation to be changed by executive order).  The extent of their use, not least in the 2008-09 session – for which he had the figures – astonished him.  He went on “I do not regard the need for resolutions, affirmative or negative, as a sufficient protection against the increasing, apparent indifference with which this legislation comes into force.”  The proliferation of such clauses, he said, would have the inevitable consequence of yet further damaging the sovereignty of Parliament and increasing yet further the authority of the executive over the legislature.  ….. the former Lord Chief Justice, Lord Woolf, had strongly criticised the Bill, not least for the inclusion in Schedule 7 (now referred to by some peers as ‘death row’) of a number of quasi-judicial bodies.’  [JE adds: Quasi-judicial bodies, the same as the CHRE/PSA, HPC, Skills for Health, NICE clinical Guidelines, IAPT, Chartered status, and so on]

 

Content

1.  My critiques of the underpinning of the regulation within Health

2.  Signposts to further information

3.  Critique of the HPC’s adulatory press-release

4. Conclusions

My apologies – this CON-sultation only passed over my desk 5 days ago – so this has been thrown together.

 

1.  My critiques of the underpinning of the regulation within Health

 

1) The assertion in the Health Professions Order 2001 and elsewhere that the production of ‘safeguarding of  health and wellbeing’ can be produced by the raft of centralising controls put in, has nowhere been proved.  It is politicians’ wish-lists and fantasies made law. See the Lord Chief Justice’s reference to King Harry’s power in the above blog.  I argued these points in 2007: the article is available here: Wellbeing & Happiness as used by the UK Government by Julia Evans on May 7, 2007 or here http://www.lacanianworks.net/?p=11

2)  Nowhere has it been proved that criminals: murderers (Dr Shipman), rapists, extortionists, will be prevented from their criminal acts by the government setting up a secondary police forces to eliminate risk and safeguard.

3)  Nowhere has it been proved that what is in place is not satisfactory. The talking therapists have for more than a century ran their own trainings, supervision and discipline procedure. Where is the evidence that this is unsatisfactory?

4) Nowhere have the gaps in current procedures been found and suggestions for how they might be filled put forward.  This delusional system has just been plonked on top, razing everything that has been developed over centuries.

5)  Any grown-up study into the impact of the Government’s delusional system into health care, for example the King’s College study  [i] , is ignored.  This Government only wants ‘research’ which supports their delusional system of what needs to be in place and the cost savings they wish to make.

6) Nearly all treatments provided by practitioners in the area of health are motored by relationships of trust.  This is applicable to conditions with a physical symptom as well as those where physical symptoms cannot be traced, as in mental health. So how do you train and regulate those who work within relationships to effect cures?  This raft of regulation: HPC, NICE, Skills for Health, IAPT, CHRE/PSA, etc rely on bodies of knowledge (see my paper: Psychotherapy is imposed: Psycho-analysis© works: Psychoanalysis operates by Julia Evans on December 15, 2010 or available here http://www.lacanianworks.net/?p=226 )  which is held in a library of standards (see the Government’s July 2011 White Paper or my critique available here: Reply to CON-sultation: Equity and excellence: Liberating the NHS White Paper July 2010 by Julia Evans on October 9, 2010 or here http://www.lacanianworks.net/?p=231  ).  It is true that manufacturing process, which are the interface between a human subject and a machine, rely on such manuals, though as interpreted by skilled operatives. Is such top-down control (King Harry’s power) appropriate to practices motored by relationships by two equal human beings? Is the use of standards in training appropriate to processes tackling conditions with no physical symptoms? Is supervision a safe place to share and learn from difficulties, or is it to ensure that standards and targets are being met?  As mistakes are forbidden in the Government’s delusional system then no learning from mistakes is allowed, by decree.

 

There are many consequences of this:

– This form of top-down absolute power does not recognise individual difference. It does not compare what is going on with precedent, as in Criminal and Civil law. It is absolute. It is THE Truth. There are no fudge areas – you are either competent or not.  You are either safe to practice or charlatans intent on criminal acts.

– It insists that practices, involving relationships of love and trust, can be codified as the ONE knowledge, from which operating manuals, as in a factory-production line or on the till at Tesco’s, can be derived.

– It insists that there is such a human being as THE normal one or THE standard one, with which imaginary ideal, comparisons can be made so, for example, your family life is sub-standard as your beds are not made when the social worker visits.

– It removes human beings’ subjectivity or individuality. It makes them into objects of exchange. So instead of sharing a common humanity, human BEINGS become measurable along these imaginary ideals or standards.  If you are a client, your symptoms become measurable in economic terms, or against the Government’s system of diagnosis: NICE and if you are an operator, you can be dragged through the Government’s fitness-to-practice courts and labelled as bad.  So much more sophisticated than the stocks, don’t you think?

– It supports the Government’s high-risk health industry, see Lord Donaldson’s – the Chief Medical Officer – report ‘Consultation analysis report: Good doctors, safer patients and The regulation of the non-medical healthcare professions‘ February 2007.  (These issues are also explored at Lacanian Works : here -Registration and Regulation – an attempt at an update and the Government’s Happiness/Wellbeing Factories reappear by Julia Evans on May 19, 2011), by providing the base-line meanings from which judgments can be made.  Questions of definition of a human subject, are never asked.  It is assumed they can be treated as objects to be manipulated and controlled.

– It imposes a system of control which is inappropriate for the area it is used. It forecloses on human relationships.

 

And it does not work – the latest example: ‘A leading private health company, poised to win much of the new wave of NHS out-sourcing contracts, is under investigation for allegedly providing an “unsafe” out-of-hours GP service, and over claims that it manipulated results where it failed to meet targets.’  From Private healthcare firm probed over ‘unsafe’ GP services: by Felicity Lawrence: The Guardian: Saturday 26th May 2012.

 

2.  Signposts to further information

Some of the material which has been produced over the last 10 years:

References to CHRE/PSA – one of the Government’s enforcement agencies – in LW

“It feels like a train crash happening in slow motion…”: One of Tesco’s top 10 shareholders.  by Julia Evans on April 4, 2012 or here http://www.lacanianworks.net/?p=322

Simplification is necessary in research. But it has limitations in providing a grand theory of everything. by Julia Evans on March 3, 2012 or here http://www.lacanianworks.net/?p=262

It is now officially evidence-based: NHS will have to ration further treatments… by Julia Evans on February 27, 2012 or here http://www.lacanianworks.net/?p=247

Sadeian power, the UK Government……… & CON-sultations by Julia Evans on February 3, 2012 or here http://www.lacanianworks.net/?p=232

‘Meno’, Montaigne and the ‘Docta Ignorantia’: Some thoughts and comments on the weak symbolic in the 21st century by Bruce Scott on January 21, 2012 or here http://www.lacanianworks.net/?p=245

This pace of moral decision-making poses insuperable challenges to several ways of thinking about right and wrong…. Giles Fraser by Julia Evans on January 20, 2012 or here http://www.lacanianworks.net/?p=249

Trust no one with your money [or health] is the tragic legacy of the crisis by Julia Evans on January 18, 2012 or here http://www.lacanianworks.net/?p=228

Getting off on old jouissance: Turning away from negative capability. by Bruce Scott on November 12, 2011 or here http://www.lacanianworks.net/?p=150

The collation of information on Government action continues… by Julia Evans on September 29, 2011 or here http://www.lacanianworks.net/?p=112

Government action closes existing facilities so contracted-out services can be used (& controlled): case 1 by Julia Evans on September 29, 2011 or here http://www.lacanianworks.net/?p=110

So who is in bed with whom (part 1)? & further on the Government’s CON-sultation mechanisms by Bruce Scott on September 28, 2011 or here http://www.lacanianworks.net/?p=104

It seems as though the HPC has died and been reincarnated into the PSA (formerly CHRE), a bit like when Doctor Who dies and comes back in a different form. by Bruce Scott on September 22, 2011 or here http://www.lacanianworks.net/?p=100

How Government Action goes wrong…. ‘The report says the department pushed ahead without undertaking basic project approval checks, taking decisions before testing the ideas for feasibility.’ by Julia Evans on September 20, 2011 or here http://www.lacanianworks.net/?p=98

Laing was rattling the cage of an establishment with vested interests who did not like to be questioned or held to account. by Julia Evans on September 6, 2011 or here  http://www.lacanianworks.net/?p=97

Sadeian power in use: By having its hand on Asia’s water tap, China is therefore acquiring tremendous leverage over its neighbours’ behaviour by Julia Evans on August 31, 2011 or here  http://www.lacanianworks.net/?p=91

An historical look at treatments for human conditions of mental distress – are the same parameters still driving treatments? by Julia Evans on August 24, 2011or here  http://www.lacanianworks.net/?p=90

About regx2 & principles for action by Julia Evans on August 13, 2011 or here  http://www.lacanianworks.net/?p=28

The two laws, limits and position: a new post by Julia Evans on July 10, 2011 or here  http://www.lacanianworks.net/?p=65

Registration and Regulation – an attempt at an update and the Government’s Happiness/Wellbeing Factories reappear by Julia Evans on May 19, 2011 or here http://www.lacanianworks.net/?p=13

Same old, same old at the HPC: HPC council meeting Thursday 31st March 2011 by Bruce Scott on March 31, 2011 or here http://www.lacanianworks.net/?p=19

Battle positions : Health and Social Care Bill January 19, 2011 by Julia Evans on February 1, 2011 or here  http://www.lacanianworks.net/?p=25

Book Review :A review of Irving Kirsch, The Emperor’s New Drugs: Exploding the Antidepressant Myth.   by Richard House on February 28, 2010. Available here http://www.lacanianworks.net/?p=26

 

ii) References to the ‘Famous Five’, regulatory capture at work, in LacanianWorks:

Sadeian power, the UK Government……… & CON-sultations by Julia Evans on February 3, 2012. Available here http://www.lacanianworks.net/?p=232

This pace of moral decision-making poses insuperable challenges to several ways of thinking about right and wrong…. Giles Fraser by Julia Evans on January 20, 2012 or available here http://www.lacanianworks.net/?p=249

Collaborators win: Putting the State Wellbeing Strategy to work….. by Julia Evans on February 8, 2011or available here http://www.lacanianworks.net/?p=101

Battle positions : Health and Social Care Bill January 19, 2011 by Julia Evans on February 1, 2011 or available here http://www.lacanianworks.net/?p=25

Psychotherapy is imposed: Psycho-analysis© works: Psychoanalysis operates by Julia Evans on December 15, 2010 or available here http://www.lacanianworks.net/?p=226

An explanation of Jacques Lacan’s use of cartels in organisational structure by Julia Evans on November 1, 1997 or available here http://www.lacanianworks.net/?p=81

 

Refences to the Merits of Statutory Instruments Committee & its critique of the HPC’s use of power

Sadeian power, the UK Government……… & CON-sultations by Julia Evans on February 3, 2012 or here http://www.lacanianworks.net/?p=232

How Government Action goes wrong…. ‘The report says the department pushed ahead without undertaking basic project approval checks, taking decisions before testing the ideas for feasibility.’ by Julia Evans on September 20, 2011 or here http://www.lacanianworks.net/?p=98

About regx2 & principles for action by Julia Evans on August 13, 2011 or here http://www.lacanianworks.net/?p=28

Comments on the HPC’s declaration of aims – 31st March, 2011 by Julia Evans on April 11, 2011 or here http://www.lacanianworks.net/?p=20

Battle positions : Health and Social Care Bill January 19, 2011 by Julia Evans on February 1, 2011 or here http://www.lacanianworks.net/?p=25

Psychotherapy is imposed: Psycho-analysis© works: Psychoanalysis operates by Julia Evans on December 15, 2010 or here http://www.lacanianworks.net/?p=226

Reply to CON-sultation: Equity and excellence: Liberating the NHS White Paper July 2010 by Julia Evans on October 9, 2010 or here http://www.lacanianworks.net/?p=231

Wellbeing & Happiness as used by the UK Government by Julia Evans on May 7, 2007 or here http://www.lacanianworks.net/?p=11

 

3)  Critique of the HPC’s adulatory press-release

 

Available on the Health Professions Council’s web-site, here http://www.hpc-uk.org/mediaandevents/news/index.asp?id=473

 

Thank you to the regx2 member who drew my attention to this.

 

Quote: ‘ In our view, the consultation proposals strike the appropriate balance between flexibility for the regulators, consistency and accessibility of statutory regulation and appropriate scrutiny and oversight. We particularly welcome the proposal to increase the parliamentary accountability of the regulators.’

‘Whilst the proposals overall will appropriately modernise and simplify the legislative framework, they may in places lead to an unhelpful divergence of approach across the regulators. We highlighted in our response the areas of importance for public protection and public confidence in statutory regulation. As well as where we considered it important for the statute to be prescriptive and for the regulators to be permitted less discretion than that proposed.’  End quote

 

Anything, which the HPC thinks is a good idea, is to be avoided. Mostly because they are required by statute, the Health Professions Order 2001, to safeguard or protect (see the last point above), which a perverse act and impossible by definition and because they are also into protecting their own, very well-paid jobs in a recession.

 

Questions:  How can you increase Parliamentary accountability when these organisations answer directly into the Privy Council? Parliament ceased to be relevant when Parliamentarians, lazily, voted this Order in place.  These whole sets of regulations need to be taken from the Statute book as there has been no necessity report, no impact analysis and those affected have not been consulted in a fair, open manner.

 

How does the HPC know that this strikes the appropriate balance?  There has been no necessity report, no impact analysis and no investigation into what is already in place.  They are merely giving their opinion, which is hardly from a non-interested position. It has as much validity as my opinion which has been ignored and side-lined for at least a decade.

 

How does the HPC contribute to public protection?  Where is the evidence?

 

Where is the evidence that the statute needs to be prescriptive? Are you dealing with a master-slave relationship or with human beings working within relationships of love, care and trust?

 

Where is the evidence that regulators are needed above what the professional associations already in place, provide?

 

And has anyone read ‘Animal Farm’?

 

4.  Conclusions

 

Why is it dangerous?

All of these regulatory organisations use direct, top-down power, King Harry’s power and apply the certainty of a knowledge which can be tabulated.

 

Over the last 10 years I have circulated many examples of how, this factory-production-line mentality does not work with real, live, individual human beings. Many are posted to LacanianWorks.net.

 

– the promise of safeguarding or risk-free.  It is impossible for any agency to promise to protect.  Well, no!! Governments and other agencies have been doing it for centuries so it is not impossible to promise – just to deliver.  Other agencies who have promised protection include: the Holy Inquisition  which protected you against hell, the Third Reich which protected you against Jews and other undesirables, and so on. Do we really wish for Government agencies which are into providing protection in this manner?

– these provisions set up a parallel police force.  I know and understand, that it is a criminal act to physically abuse or kill a client, to sexaully abuse a client, to intimidate or bully a client, or financially abuse them.  So do tens of thousands practitioners within the talking therapies and other health services. We understand and obey criminal law.  So why is it necessary for the Government to invent a parallel police force to ensure these abuses do not take place?  Where is the evidence?

 

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3)  The Law Commission’s acknowledgement of receipt

 

From: Julia Evans

Sent: 31 May 2012 20:05

To: LAWCOM Public

Subject: Response to the Law Commission’s CON-sultation

Dear Tim Spencer-Lane,

Attached please find my response to the Law Commission’s CON-sultation

Yours faithfully

Julia Evans

Lacanian Psychoanalyst

w:  http://www.LacanianWorks.net

w:  http://www.psychoanalysislondon.org.uk

Practice Rooms:  Flat 1 (Basement Flat), 32 Nevern Square, Earl’s Court, London, SW5 9PE

******

From:             Leslie, Justin [Law Commission]

Subject:         RE: Response to the Law Commission’s CON-sultation

Date: 1 June 2012 15:37:57 GMT+01:00

To:      Julia Evans

Dear Julia,

Many thanks for your response to our consultation on the regulation of health and social care professionals. Your comments are very much appreciated and have now been submitted as a formal consultation response. We treat all responses as public documents in accordance with the Freedom of Information Act and we may attribute comments and include a list of all respondents’ names in any final report we publish.

Please do get in touch if you would like any further information.

Kind regards,

Justin Leslie

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4)  Circulation list within both Houses of Parliament:

a) Covering note

a)  the note which introduced my response to Members of both Houses

 

Dear

 

I draw your attention to my recent response to the Law Commission’s CON-sultation.

 

As those of you who were around in Parliament between 2007 and 2010 will know, I have circulated information previously. This message marks the resumption of my practice of circulating certain key documents that aim to highlight what perverse effects your actions are producing.

 

I note, that the Government’s mania for protecting, has not abated.  You still hold the firm opinion that you, legislating centrally, can protect the population against those, calling themselves health professionals, who wish to act criminally against their subjects.  You have no evidence, but never mind, it makes you feel that you are in control.  It also means you can disguise cuts in services as ‘efficiency savings’.

 

I also note that you, acting centrally, believe you can wave your magic wands, and produce health, well-being and probably happiness, by applying standards and competences from Skills for Health, NICE (which gives clinical judgments leading to prescribed, standard treatments),  to the areas of practitioners’ training, practice, ethics via HPC or CHRE/PSA. There has never been any evidence that this is the case but never mind, you give orders to raze that which is in place and replace with your control systems.

 

I circulate this to start you critiquing what you have put in place and, hopefully, taking responsibility for the consequences of your action.

 

Thank you for your attention.

 

Yours sincerely

Julia Evans

b)  Circulation list

 

Rt Hon Dr Vince Cable MP – Julia Evans’ constituency MP

Rt Hon Andrew Lansley CBE MP , Secretary of State for Health

Mr Paul Burstow MP, Minister of State for Health (Care Services)

Rt Hon Andy Burnham MP, Shadow Secretary of State for Health

Baroness Thornton, Shadow Minister for Health, Health Spokesperson – the House of Lords

Lord Beecham, Shadow Health Spokesperson, House of Lords

Lord Carlile of Berriew, Former Lib-Dem Spokesperson & member of the Joint Committee on the draft Mental Health Bill

House of Commons Select Committee on Health

Government Members

Rt Hon Stephen Dorrell  (Chair)

Mr Andrew George MP (Lib Dem)

Dr Daniel Poulter (& Member of Mental Health All-Party Parliamentary Group)

Mr Chris Skidmore MP

Mr David Tredinnick MP

Dr Sarah Wollaston MP

Opposition members:

Ms Rosie Cooper MP

Ms Barbara Keeley MP

Mr Grahame M Morris MP (& Member of Mental Health All-Party Parliamentary Group)

Mr Virendra Sharma MP

Ms Valerie Vaz MP

Member of the Constitution Committee

Baroness Falkner of Margravine  Lib Dem

Former member of the Merits of Statutory Instruments Committee

Viscount Eccles  Conservative

Mental Health All-Party Parliamentary Group

Purpose:  To inform parliamentarians about all aspects of mental health.

Chair:  Mr Charles Walker  MP  Conservative

Vice-Chair: Ms Alison Seabeck MP, Labour

& Ms Nicky Morgan MP Conservative

Secretary: Baroness Murphy of Aldgate, Crossbench

Sir Peter Bottomley MP – Conservative

Mr Chris Heaton-Harris MP – Conservative

Mr Damian Hinds MP – Conservative

Mr Guy Opperman MP – Conservative

Mr James Morris MP – Conservative

Ms Penny Mordaunt MP – Conservative

Ms Jo Swinson MP – Lib Dem

Mr David Wright MP – Labour

Ms Kerry McCarthy MP – Labour

Mr Mike Gapes MP – Labour/Co-operative

Mr Alun Michael MP – Labour/Co-operative

Mr Jim Dobbin MP – Labour/Co-operative

Dame Anne Begg – Labour

Mr Russell Brown MP – Labour

Mr Jon Cruddas – Labour

Mr Hywel Williams – Plaid Cymru

Sponsors of the House of Commons debate ‘Mental Health’ on 14th June 2012 

Mr Charles Walker MP, (See Select Committee on Health above)

Sir Peter Bottomley MP, (See Mental Health All-Party Parliamentary Group  above)

Mr Jon Cruddas MP, (See Mental Health All-Party Parliamentary Group  above)

Mr Mark Durkan MP, – Social Democratic and Labour Party

Dr Julian Lewis MP – Conservative

Ms Nicky Morgan  (See Mental Health All-Party Parliamentary Group

above)

Mr James Morris  (See Mental Health All-Party Parliamentary Group  above)

Speaker at the House of Commons debate ‘Mental Health’ on 14th June 2012 

Mr Kevan Jones MP - Labour : See  http://www.guardian.co.uk/uk/the-northerner/2012/jun/15/mental-health-parliament-debate-kevan-jones?newsfeed=true  : ‘A shining moment in the Commons as MPs hear that even their own mental health doctor struggles for funds.’

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[i] Gerry McGivern, Michael Fischer, Ewan Ferlie,  Mark Exworthy: Statutory Regulation and the Future of Professional Practice in Psychotherapy and Counselling:Evidence from the Field:  Published at King’s College, London website, here,  October 2009:  available here: