---

Health Care and Associated Professions (Miscellaneous Amendments and Practitioner Psychologists) Order 2009

My Lords, as a member of the Merits of Statutory Instruments Committee, let me say that there are some technical deficiencies in the order. I will not concentrate on those tonight, although I will refer to one or two. I am not as sanguine as my noble friend Lord Howe is about the benefits of statutory regulation and would like to emphasise what the noble Baroness, Lady Pitkeathley, said about independence. The great problem with all systems of statutory regulation that I have been involved with is that it is very difficult to believe that you have the independence that you were promised. I have debated the independence of public bodies a number of times in this House and usually I have been disappointed. On this occasion, deep within the 51 pages of the order, we come upon Schedule 4, which consists of three and a half pages of amendments to legislation to bring seven categories of "protected title" psychologists under statutory regulation by the Health Professions Council, thus splitting the British Psychological Society down the middle, as its members have testified and as we have been told tonight. The statutory regulation of psychologists takes us on to new ground. It is a most significant proposal. Why is it before us? Relying on material put before the Merits Committee, and I hope not being too unkind, I think that the purpose is allegedly to modernise. This is the first new Labour mantra prayed in aid. There are two more: patient safety and public confidence. The problem is that no evidence is produced and no argument made, in the explanation of this order, that the modernisation will improve patient safety or public confidence. It is taken as a given. Nor is any argument made that either patient safety or public confidence is a problem when it comes to psychological practice. The regulatory impact assessment simply states that government intervention is necessary. "Necessary" is a strong word. We are not told why, but I think that we know why: it is an a priori judgment by the Government. As we know, new Labour has a strong preference for Secretary of State-controlled statutory regulation. What results from this state-controlled mechanical agenda is an increase from 134 HPC malpractice allegations in 2003-04 to three times that number in 2007-08, against a 30 per cent—less than one-third—increase in practitioners regulated under the 13 present headings. Psychologists will take the HPC on to new ground: matters of the mind. The attempt to codify and define will open the door to a rapid rise in imaginative allegations. One needs only to look at the prescriptive detail that the HPC thinks is appropriate for psychological qualification. Does the Minister really believe that a rising tide of allegations is, or ever will be, a good indicator of patient safety or public confidence? There is also the dilemma of the consultation already referred to by my noble friend on the Front Bench. Why is it that many deeply held convictions of professionals were not expressed in the Government’s record of the consultation, when the Merits Committee, unusually, received many well argued representations that statutory regulation will not benefit the public? Nothing in the Explanatory Memorandum or the regulatory impact assessment implies any controversy, yet there is plenty about. Why the gap in perception? First, it is the centralised, all-powerful NHS effect—the fear of being on the wrong side of a controlling Government who hold many of the purse strings. The loss of employment can turn people into collaborators. Secondly, the consultation questions make it clear that statutory regulation will happen. They ask nothing about patient safety or about public confidence, present or prospective. The heart of the matter is left as an unarguable tautology: modernisation is by its very nature good. Finally, there will be additional costs, recoverable, no doubt, through fees. The HPC’s costs have been rising sharply and it has had to take a significant property impairment charge. This all looks pretty amateur to this old servant of the public. Any rise in costs is to be doubly deprecated in today’s circumstances. We are probably stuck with the order, or at least the psychological part of it, but it should be the last with "psy" in the title.