Domestic Abuse Bill

Debate between Lord Alderdice and Baroness Finlay of Llandaff

Report stage
Wednesday 10th March 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, we discussed in Committee that there are no laws against anyone operating as a therapist, psychotherapist or counsellor. Cheap online courses allow people to cheat to complete them, leading to qualifications that are often meaningless. The Health and Care Professions Council is a statutory regulator for practitioner psychologists in the UK. “Registered psychologist” and “practitioner psychologist” are protected titles, as are the specialist titles “clinical psychologist”, “counselling psychologist”, “health psychologist” and others. The title “chartered psychologist” is also protected by statutory regulation, meaning that a psychologist is a chartered member of the British Psychological Society, but not necessarily registered with the Health and Care Professions Council. However, the title of “psychologist” by itself is not protected, meaning that if psychologists do not use one of the protected titles, they can offer their psychological services without any regulation. The public have no idea that these people are not regulated in any way; even if serious concerns are expressed or complaints raised about them, they remain immune from investigation because they are not registered.

These people can wreak huge harm and havoc in other people’s lives. They can drain them of all their finances, create false assertions, produce false evidence and exploit them, driving them away from family members who love them and would support them, and trapping them in a cycle of ever more dangerous psychological dependency. Yet, the victims of such charlatan practitioners have no redress. That is why this amendment is needed and I strongly support it.

[Lord Alderdice (LD) [V]]

My Lords, in addition to the powerful arguments that have already been brought by noble friends, I have a few more. The first question is whether the amendment is appropriate to a Bill about domestic abuse. Few would argue that the victims of domestic abuse are not entitled to seek emotional and psychological help and support. The problem is that, either when they are undergoing the abuse or when they are trying to put their lives back together after a period as a victim of abuse, they are likely to seek psychological help.

If they can access psychotherapists, psychologists or others through the health service, there is a degree of protection. Even in a context where there is no statutory registration of psychotherapists working within the health service, as is the case, there is a degree of protection for the patient or client. But the majority of psychotherapists do not work in the health service; they work in private practice, community facilities or voluntary organisations, but not in the health service.

This produces two kinds of vulnerability. First, as we have already discussed, the victims themselves are open to be abused by those who claim to be psychotherapists, but who have a malign influence. I do not think I would have to go terribly far in your Lordships’ House to find uncertainty or confusion about what is a psychiatrist, psychologist, psychotherapist or similar title. One could hardly expect vulnerable victims to be more able to parse and find an appropriately trained person.

There is a further complexity, which has been made worse by Covid. Many perfectly reasonable and helpful people who are not registered psychotherapists and, in some cases, are not registered with any organisation never mind statutorily are working in quite isolated situations themselves now. I have talked to some psychotherapist colleagues, who are working from morning until night, every day of the week, on Zoom, with very vulnerable people. They are isolated themselves, socially and professionally, so their relationships with their patients and clients begin to have a degree of dependency. These people are not even professionally protected so, apart from the malign individual who consciously exploits the victim of domestic abuse, either currently or after their victimhood, it is not hard to see how a person who is not particularly malign may find themselves behaving in that way, for a series of psychological reasons.

What is troubling is that the knowledge of this has been around for a long time. In 1971, the Government commissioned and received a report from Sir John Foster. It was stimulated by concern about the Church of Scientology, but it looked at people who used coercive or controlling behaviour when providing psychotherapy or counselling services under that institution. The recommendation was that there needed to be registration —50 years ago. In 1978, Paul Sieghart produced a report with the same recommendations and, in 1981, Graham Bright produced a Private Member’s Bill in the other place based on Paul Sieghart’s report to register psychotherapy.

When I was appointed as the first consultant psychiatrist in psychotherapy in Ireland, north or south, I started training in psychotherapy through the medical faculty at Queen’s University Belfast, not just for those who were medically qualified but for others who were not, to enable them to become properly qualified. However, I quickly discovered that there was lots of what I call “wild psychotherapy”, so I talked to the Department of Health and Social Services, which agreed and provided some funds. We appointed one of my staff, Gillian Rodgers, to do a report, and she presented it to the department in May 1995—nothing was done.

United Kingdom Internal Market Bill

Debate between Lord Alderdice and Baroness Finlay of Llandaff

Committee stage & Committee: 5th sitting (Hansard) & Committee: 5th sitting (Hansard): House of Lords
Monday 9th November 2020 Lords Chamber

[The Deputy Chairman of Committees (Lord Alderdice) (LD)]

The noble Lord, Lord Purvis of Tweed, has withdrawn, so I call the noble Baroness, Lady Finlay of Llandaff.

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, like other noble Lords, I pay my respects to the memory of Lord Sacks. His loss is immeasurable, and I am sure he would have contributed enormously this evening.

I have put my name to the proposal of my noble and learned friend Lord Thomas of Cwmgiedd that Clause 50 should not stand part of the Bill for a number of reasons. First, the clause is in direct contradiction to Ministers’ assertions that the Bill does nothing to remove powers from the Senedd. If that is the case, why is a new reservation necessary?

Secondly, and related to this, is the conundrum that the Government insist that state aid is already reserved. This position has long been strongly contested by the devolved Governments, who have always operated the state aid system, as the UK Government do in England. If there is doubt about the current legal disposition, would it not be better to ask the courts to interpret the meaning of the current reservation and whether it does or does not include state aid?

Thirdly, although I am no expert, I understand that the Government have been resisting pressure from the European Union during the still-ongoing negotiations to keep in place a state aid framework broadly similar to the one we have inherited through our membership of the EU. Indeed, the statutory instrument to revoke all state aid law is before this House. Why are a Government that seem so reluctant to commit to a rules-based system also so eager to take to themselves absolute power on this vital area of economic development policy?

The devolved Governments in Cardiff and Edinburgh are both in favour of retaining this framework in retained EU law. It is a clear system that provides a bulwark against the arbitrary use of public subsidies to support businesses in favour with the Government or to attract investment, something that is a real risk. Having the protection that this current situation affords for the Governments of the smaller nations of these islands is important because, at the end of the day, the UK Government in their “Government of England” mode can always trump any financial incentives that the devolved Administrations could offer in some kind of dog-eat-dog contest. This clause simply feeds the suspicion that, rather than maintaining a level playing field across the UK, this element of the Bill is about giving the Government the maximum freedom to do what they like with the system and channel investment to marginal Conservative seats.

Fourthly, it is probable that, despite their effort, the Government do indeed sign up to an agreement with the EU that requires the enhancement of a new system of state aid. I hope that the term “subsidy control” evaporates in the way the “implementation period” seems to. If that is the case, then the devolved institutions will have to conform to those new rules because they flow from an international treaty obligation, so this new reservation will be unnecessary.

Finally, I turn to what this clause, like so much else about this Bill, says about the Government’s approach to devolution. Quite simply, it would seem that they do not like it, would prefer it not to exist and want simply to pay lip-service to it. This is a Government that do not seem to tolerate any source of law and public policy that they cannot control and, having removed the rival source of authority of the EU, seem to be gunning for other bodies that have the power to make primary legislation. This is not just distasteful; it is profoundly dangerous for those of us who care deeply about the union. I appeal to the Government to rethink their approach urgently because, otherwise, they will see the country gradually disintegrate in front of their eyes.

[Viscount Trenchard (Con) [V]]

My Lords, when I read the three amendments of my noble friend Lady Rawlings, I was not sure exactly what had driven her to propose them. Of course, I am aware that my noble friend is a distinguished former chairman of King's College London and, therefore, well aware of the importance of research and development grants. I recognise the importance of regulating the provision by public authorities of subsidies that may be distorting or harmful.

I had thought that Clause 49 makes it clear that financial assistance for economic development may be provided in a number of forms, including grants. However, I sympathise with my noble friend’s view, which she clearly explained in her impressive speech, that R&D grants should be incorporated to safeguard against unfair state aid masquerading as legitimate subsidies. I would like to hear the opinion of my noble friend the Minister on this question.

Regarding the proposal of the noble and learned Lord, Lord Thomas of Cwmgiedd, that Clause 50 should not stand part of the Bill, although I have the greatest respect for his opinions and was impressed by his characteristically clear explanation of his reasons, I believe it is still necessary for this clause to protect against the undesirable possibility that the devolved authorities might otherwise adopt significantly different regulations on this. I look forward to hearing what my noble friend the Minister has to say about this amendment and the need for a single nationwide state aid regime.

Health and Social Care Bill

Debate between Lord Alderdice and Baroness Finlay of Llandaff

Monday 19th December 2011 Lords Chamber

[Lord Alderdice]

It may seem a little unclear to the noble Lord, but it is not so unclear. Psychologists are qualified as psychologists, not as psychotherapists or as counsellors—they belong to a different professional body and have different qualifications and requirements. Psychologists themselves campaigned for many years for statutory regulation and finally got it through the Health Professions Council. Arts therapists and so on went through the HPC because many of them were occupational therapists, but try as I might—and I have been doing so for well over a decade—I cannot get successive Governments to address the question of psychotherapists and counsellors, despite the fact that they constitute a far larger number of people.

My dilemma with the current set of propositions is that, of the arguments adduced to try to persuade noble Lords that a quality-assured voluntary registration scheme is appropriate because the people referred to—the physiologists, the perfusion scientists and so on—are operating within the health service under supervision, are employed there and are smallish in number, none of them applies to this other group of people, for whom I have had precisely the same reply from the Minister. Therefore, I am keen to hear from the Government what the set of criteria is. Is it simply that this Government are not keen to pursue anything in the way of regulation except at the most modest level? If so, that is a legitimate argument but it needs to be made. If not, then I do not quite see the consistency of the current application.

[Baroness Finlay of Llandaff]

Perhaps I may add a small point. I do not know how many physicians in anaesthesia are employed in operating theatres in private hospitals, where an enormous amount of private surgery is done. One of the main reasons for people going to a private hospital is for surgery—particularly elective orthopaedic surgery. Therefore, although I cannot put any figures on this, I do not think that it is correct to assume that these people are necessarily operating only in the NHS and are subject to current NHS structures.

In the new world where we will have a broad range of providers, it will become even more important to know that there is a minimum standard and that all the people at each step of the way will be answerable. The patient may well choose to go to an organisation where these people are employed but the patient will not know that. No one gives him a list and says, “Of all these people looking after you, these will be statutorily registered but these may or may not be on a voluntary register”. If we are thinking about patients taking informed decisions regarding their future, I suggest that the coroners’ reports that we have had to date should already be sounding alarm bells.

Health and Social Care Bill

Debate between Lord Alderdice and Baroness Finlay of Llandaff

Tuesday 25th October 2011 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, perhaps I may briefly intervene to try better to clarify my concerns. I am not asking that small providers should have to account for all the education they provide. Let me give a specific example. If you have a hospice home care team, it is very appropriate that they should take nurses under training on placement. They can go out with the specialist nurses and learn about provision in the community. It will not cost the hospice anything, but the hospice management might feel that having students around is difficult because of regulatory functions and so on. All I am saying is this: if the management says that it will not take on students to learn about its excellent clinical service, it must justify why it is closing that educational door.

Similarly, if a group of physiotherapy providers dealing with back pain has an NHS contract, it would seem appropriate that it should take on physiotherapy students in order that they can observe and learn ways of managing back pain, which is what the group is primarily dealing with. Those students will get very good training. If the group says, “We do not want to take students”, then I suggest that it would be appropriate to point out in the contractual process that it needs to justify why it is refusing to provide education. Also, perhaps that group should not receive the full tariff because other providers will want to share their expertise for the greater good.

[Lord Alderdice]

My Lords, as I say, I understand the sentiments that the noble Baroness is trying to convey, but one has to be careful about generalising from one’s own experience, which might not necessarily fit everywhere. For example, a noble Lord said earlier that in a lifetime of clinical work, only a couple of patients had ever said that they did not want a trainee sitting in. I am afraid that psychiatry and the psychological services are a wholly different ball game. Whenever we were setting up for trainees, we had to warn them in advance that one in every three patients would not allow them to sit in on an assessment because of its personal nature. When you are living in a smallish community, as mine is, where people know people who know people, these things are much more of an issue.

It you make demands of some of the NGOs and smaller community services—demands that may be completely appropriate in a larger setting such as hospice care—that is quite a different thing. I accept absolutely what the noble Baroness is saying, but please let us not make a rule for everybody which may detract from some provision that is entirely appropriate.