Domestic Abuse Bill — House of Lords, 2021-02-08
Topic: Health
Philip Alexander Hunt (Labour, Centre-left): My Lords, I welcome the amendment of the noble Lord, Lord Marks, and the opportunity to talk about the role of psychotherapists. As I will be discussing regulatory issues, I declare my membership of the GMC I have no doubt about the value of psychotherapists and the beneficial impact of their work for so many people. But there are potential risks, which the noble Lord, Lord Marks, referred to eloquently when we last debated the amendment. Also, in a Lords debate on 2 March last year, he said: "We have heard harrowing accounts of victims, often young, brainwashed by unscrupulous and controlling individuals. These charlatans play on their clients’ suffering, deluding them into a false belief in their treatment, often conjuring up in them fake memories about their early years and inducing unhealthy long-term dependence on the therapist and rejection of families and friends."—[Official Report, 2/3/20; col. 477.] That was reinforced by the case the noble Baroness, Lady Jolly, just referred to Patients and clients can be vulnerable, and an insensitive, critical or sexually exploitative therapist could increase the risk of the patient having a poor—and potentially damaging—outcome from their therapy. The big problem is that the terms "psychotherapist" and "counsellor" are not protected. Any one of us could call ourselves one of those titles and advertise our services to unsuspecting and sometimes vulnerable people. I have long had worries about this, going back to when I was a Health Minister, some 20 years ago In 2001, the noble Lord, Lord Alderdice, introduced a Private Member’s Bill to provide for the regulation of psychotherapists and make provisions to enable the registration of the profession. Since then, we have established workstreams to look into regulation, but, unfortunately, the profession found it difficult to reach a common cause, principally because there were so many different, and sometimes conflicting, schools of thought That, I am afraid, was the start of a long and unhappy journey. In 2007, the then Government published a White Paper which included plans to introduce statutory regulation for psychotherapists and counsellors. But, unfortunately, by 2010, this did not import into statute, even though, by then, the noble Lord, Lord Alderdice, had done a sterling job in pulling the different psychotherapy schools together and getting agreement on the way forward. We then had the coalition Government in 2010, which announced a new approach to regulation and a belief that centralised statutory regulation was not always the most effective or efficient way of ensuring high-quality care. That, essentially, is where it stayed The debate in the name of the noble Baroness, Lady Jolly, last March, induced the following response from the Health Minister, the noble Lord, Lord Bethell: "The Government are committed to a proportionate system of safeguards for the professionals who work in the health and care system … Where practitioners pose a direct risk of harm to the health and well-being of patients, legal avenues will and must be explored … However, more rules are not always the answer to every problem. While statutory regulation is sometimes necessary where significant risks to users of services cannot be mitigated … it is not always the most proportionate or effective means of assuring the safe and effective care of service users."—[Official Report, 2/3/20; col. 480.] He also referred to the more than 50,000 talking service professionals on the registers accredited by the Professional Standards Authority. That is welcome, but it is not statutory regulation, nor is it protection of title, which means any of us could, if we wanted to, continue to call ourselves a psychotherapist or counsellor The big problem here is that the Government are basing this on a risk assessment for which there is little evidence. There is a real lack of hard research in this area. I am grateful to the Library for unearthing a 2019 article, published in Frontiers in Psychology, which provided a potential explanation of why there may currently be a lack of quantitative research. It said: "Although the broad topic of negative outcomes has been extensively discussed, empirical research on patient safety, directly examining the causes and prevention of harm, is not well established. Because harm … is relatively rare, and not amenable to experimental manipulation, such research is difficult." In 2017, the Brighton Therapy Partnership, a continued professional development and training organisation for counsellors and psychotherapists, said: "There is very little research into the harm that properly executed therapy can cause. This is an unusual anomaly for a medical field, as in every other area research is abundant into both efficacy and failure of all treatment options." When the Government say, as I have no doubt the Minister will today, that it is not proportionate to regulate psychotherapists, there is an absence of evidence to base that on. In the meantime, in the absence of statutory regulation, the amendment of the noble Lord, Lord Marks, is essential. I hope he is prepared to support this all the way in the Bill. There is a dangerous gap, and some action needs to be taken.