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Lord Wedderburn of Charlton: My Lords, before my noble friend sits down--our friendship will long outlast his brief--in view of the novelty of the proposals and the detailed work which has plainly been done in the department, I wonder whether he will undertake to try to send copies of the draft order to those who have spoken in the debate and to place a copy in the Library?
Lord Burlison: My Lords, I thank the noble Lord for that point. I shall certainly do my best immediately.
2.26 p.m.
Lord Alderdice: My Lords, I am deeply appreciative of the time that noble Lords have given, particularly at this late hour on this day of the week. I deeply appreciate the kind words which have been said and the appropriate tributes which have been paid to the psychotherapy organisations which have been working long and hard on this matter. I value the thoughtful and thorough way in which Members of your Lordships' House have given the Bill their attention at Second Reading.
Perhaps I may briefly respond to a number of the points made. I ask for the indulgence of your Lordships, as I shall want carefully to study Hansard. Some of the speeches have been remarkably detailed and I shall want to study them thoroughly before proceeding to the next stage. I also expect to be in correspondence with a number of Members of your Lordships' House.
I turn to the remarks of the noble Lord, Lord Clinton-Davis, and his kind response, made from a fund of knowledge and long experience in this matter. He mentioned in particular the question of analytical psychology. He will know, as will other noble Lords who have read the Bill, that no modalities are currently mentioned in it. A great deal of discussion has been going on, particularly recently, about precisely how we should deal with the diverse modalities which exist.
I am happy to reassure the noble Lord that when I table an amendment, as I have undertaken to do, analytical psychology will certainly receive a reference. It would be foolish of me to respond immediately about the precise form of such an amendment. However, there is no intention to do other than to value the contribution of analytical psychology and appreciate that it would not help matters for it to be "muddled in" with other things, as the noble Lord put it. A degree of clarity is necessary, although a degree of co-operation is also appropriate between the analytical psychologists and their colleagues. There has been a great deal of such co-operation over the years.
The noble Lord, Lord McColl of Dulwich, also kindly welcomed the Bill. He, too, referred to analytical psychologists and to the fact that the Bill does not address counsellors. That is a difficult issue. It has to be a judgment as to how much can be achieved. However, I gave some thought to the fact that over the past 30 years it has not been possible to achieve success. I shall return to that in my response to the Minister. Given that difficulty, I was perhaps a little more modest in the intention of achieving something, rather than grandiose, with the likely outcome of achieving nothing at all.
The issue of counsellors and counselling needs to be addressed. It may be that that can be done in this way at a subsequent stage or time or that another arrangement is appropriate. However, one should not underestimate the difficulties of addressing the issue.
The noble and learned Lord, Lord Lloyd of Berwick, was most supportive and I appreciate that. He has great experience of professional discipline, particularly with doctors and dentists. His explanations and reference to the role of the Privy Council in this regard is extremely helpful. It will be helpful to many members of the psychotherapy profession who in reading the account of your Lordships' debate will be enlightened in an area which many of them have described to me as somewhat obscure.
I value the noble and learned Lord's appreciation of the reasons for not including counselling at this stage. In the past few years, with my various experiences, I have tended not to set the ideal as an enemy of the good. Sometimes I fear that that can be the case.
The noble Lord, Lord Hodgson, has given considerable thought to the Bill. I deeply appreciate the time and attention he has given to it. I am cautions about trying to refer to all the detailed points he made. They are important and I shall give due consideration to them. In some areas, we may be less at odds than appears to be the case and I believe that that will be evident during our discussions.
In some areas, practical implications are a problem. Perhaps I may give as an example the suspension of a practitioner; for example, a GP or a specialist in a medical area. If he is immediately suspended, some other doctor will immediately be able to undertake the treatment of all his patients. In a context particularly of intensive psychotherapy, where the patients see the same therapist frequently and for long periods of time, simply and immediately to suspend the psychotherapist may help to protect against any violence or harm which might be done to the emotions of a particular complainant but it will almost inevitably also do emotional harm to the other patients who the therapist is managing at the time. Therefore, it cannot be done without due consideration. That was a dilemma which we discussed when exploring the content of the Bill.
However, what the noble Lord said about that and other issues, particularly the involvement of the lay public, is important. Indeed, it has been my lot frequently to explain to my professional colleagues how such regulation will not be acceptable unless there is greater lay participation than would have been the position in the past and may be the case in the Bill. I do not have a closed mind with regard to that.
The noble Lord, Lord Hodgson, mentioned the burden of work which will fall on the members of the council. I readily appreciate that and his comments are worthy of consideration. However, I am given a further opportunity to pay tribute to the enormous amount of work done during the past 20 years by psychotherapists without the benefit of being part of a statutory body but determined to try to produce something good for the profession and protective of the public.
The noble Lord, Lord Wedderburn, has considerable knowledge, particularly as he has worked for some time on the Bill. I greatly value and appreciate his comments. We have discussed the absence of doctors on the register and the possible difficulty with that. Perhaps I may take that matter away and consider it. However, I am cautious about requiring professionals--not only doctors but others--to submit themselves to a whole series of registers and the potential multiple jeopardy of a series of tribunals in the case of a complaint. We must consider that matter.
However, as I turn to what the Minister said, I have ringing in my ears, and with profound sorrow on my part, the warnings which the noble Lord, Lord Wedderburn, gave about the procedure of an order. I am encouraged that the Minister was positive in his general tone. I value and appreciate his comments. Like the noble Lord, Lord Wedderburn, I am now most curious to know the details of the proposals which exist and I am perhaps sufficiently opinionated to have the notion that if they have appeared only now, after some 30 years, the process of the Bill might have a connection. That encourages me not to be wholly negative about the procedure. I do not regard any particular legislative procedure which produces an outcome as sacrosanct. It is the outcome that is important.
I have some questions about the procedure which the Minister said it was important to follow. The noble Lord referred to clinical effectiveness. However, the Minister is aware that this Bill is not about clinical effectiveness, any more than the GMC is the prime body to address the question of medical effectiveness, which is another matter. I readily accept that, as the noble Lord suggests, the NHS is not well dealt with here because doctors, nurses and psychologists do the main work of psychotherapy in the health service. However, the reason for that is that the NHS does not have confidence in employing those who declare themselves to be psychotherapists precisely because there is no agreed statutory registration. Therefore, work in psychotherapy must be carried on by those who may be described as the core professions. In my own psychotherapy department there are doctors, social workers and nurses, all of whom have trained and describe themselves as psychotherapists but can be employed within the health service only because they have also trained and are employed as nurses, doctors, psychologists or whatever. I am not persuaded that without registration in psychotherapy we are protecting the NHS or psychotherapy within it; quite the contrary.
I am puzzled by the question of whether there should be a separate council of the kind that I describe in the Bill or a more amalgamated version, as the Minister appeared to imply. Are we talking about a health services council which truly brings together all the different professions? Can such a council devise appropriate and relevant ethical, training and educational criteria to meet the needs of chiropodists at one end and psychoanalysts at the other? Chiropodists might see someone on one occasion briefly to carry out a minor physical procedure, whereas a psychoanalyst might see a patient five times a week, perhaps for many years, and the vulnerabilities and relationship as between patient and therapist might be wholly different.
There may be a danger that the Government try a one-size-fits-all approach. The dilemma which that creates is that either the one-size stockings (or whatever they be) simply burst, with unhelpful consequences for all, or nothing happens at all. The noble Lord indicated that the Government regretted that such a long time had elapsed without the
registration of psychotherapists. I ask the Minister and his colleagues to consider why that is so. Was the approach misguided because it attempted to include everything and ended up by including nothing, while the rather more modest approach that we have adopted has at least achieved some progress in addressing an important matter? Is it better that nothing is done because everything cannot be achieved or that something is achieved and can be built upon?As we have said recently in Northern Ireland, 30 years is too long a period. We have tried to do something about it. The Minister's colleague spent some time in the Province recently to try to achieve something; and the same may well be said of psychotherapy registration. Thirty years is more than long enough. I commend the Bill to the House.
On Question, Bill read a second time, and committed to a Committee of the Whole House.
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