There is a widely held belief that it is necessary for
STAT to be recognised by the CNHC as a participating professional association in order for STAT members to be able to join the CNHC register. THIS IS NOT TRUE.
Any STAT qualified Alexander Technique teacher is eligible to go on the CNHC register,
and you don't even have to belong to a professional body. Although there is a formal assessment procedure rather than being
fast-tracked, STAT and the other professional bodies can be completely independent without affecting the
eligibility of members.
This
campaign began with a letter from Mike Rawlinson sent out to half a
dozen members in June 2009. Within a week it had reached just about
every STAT member worldwide who had an email address. It is reproduced
here
Some
Thoughts on In-voluntary Regulation and Ofquack.
Over the years I’ve been sort of in favour of
regulation assuming it to be the least worst option, but recently I’ve
wondered if, in our enthusiasm for its benefits, we might have
overlooked some of the possible consequences, and this is an attempt to
redress the balance. It’s not about the technicalities, which I
don’t claim to understand, but about thinking it through - where is it
leading, and what are the likely consequences if we do go ahead? I’ve
talked to other STAT teachers, including those directly involved with
regulation, as well as those who have left STAT, and I’ve talked to
council members from other organisations that have withdrawn from the
process. It is not a structured argument for or against, but a
collection of thoughts that I hope will make some sense.
I don’t claim to be right, and in some ways I
hope I am wrong, but I trust you will be good enough to spend a few
minutes reading this with an open mind, to consider the issues, and to
cast your vote at the AGM in whatever way you feel is appropriate.
Will regulation improve our Professional Standing?
STAT is one of the few organisations still involved with voluntary
regulation.
From the start we were told that we had to include
the smaller groups to form a unified body, and although STAT represented
over 85% of teachers in the
UK
, it was ‘all or nothing’. Now we are told that if we don’t sign
up, the process will go with the smaller bodies, representing only 15%
of teachers. What does that say about the integrity of this process and
the people we are dealing with? Is this acceptable behaviour from an
organisation that presumes to regulate professional standards?
Craniosacral therapists were recently given the same ultimatum,
and the two largest groups voted against it, leaving the small groups to
get on with it. We will have to wait to see what happens next.
Now that we have a scientific validation for our work, we should
question whether it is in our interest to be on the same register as
practitioners of unproven therapies, not all of which are regarded as
credible by mainstream medicine. The more we associate ourselves with
therapies such as Reflexology and Aromatherapy, the more we give the
impression that that is the category to which we belong.
We should not assume that regulation will give us the professional
status we think it will. Many alternative practitioners want nothing to
do with it, and some large professional bodies are outspoken in their
opposition. It is a safe assumption that, those bodies and individual
practitioners will want to tell the world why they have chosen not to
register, probably accusing it of lowering standards rather than raising
them. (Note 1 below)
On the other side, the CNHC is treated with scorn and derision by
sections of the mainstream medical establishment among whom it is known
as ‘Ofquack’. NHS funding is getting tighter, and vested interests
will do everything they can to prevent NHS money being ‘wasted on
quacks and snake oil merchants’ to quote one website. Note the stitch
up of homeopathy a couple of years ago which successfully curtailed
funding for homeopathy on the NHS, including the closure of the
Tunbridge
Wells
Homeopathic
Hospital
.
Type ‘ofquack’ into Google and the CNHC site comes out at the
top of the search, and although amusing to some, this is potentially
quite serious. It’s called ‘Google bombing’. Google bombing is
usually humorous eg a search of ‘miserable failure’ used to return
George Bush’s website as the top result. However, it takes a
coordinated effort from a large number of websites with a high page rank
to carry it off (eg large organisations such as medical bodies,
newspapers, drug companies etc). In addition, Google has tried to
prevent it. The fact there are organisations prepared to invest time and
money to discredit CNHC suggests that there is a coordinated and well
organised campaign to sabotage this register, and I don’t thinkit’s doing it just for fun. Most of the other 3000 results are
filled with vitriolic abuse of the ‘quacks’ on the register, and by
joining it, we may become the subject of unwarranted derision.
The CNHC website reports that there have been a number attempts by
hackers to disable the site. There are powerful vested interests that
are determined to wreck the CNHC and we should be aware of what we may
be getting ourselves into. Although none of this is a reason for not
joining the register if we believe it to be a good thing, we should be
aware that our assumptions of resulting professional credibility may be
wrong, and it could do a great deal of damage to our profession which
currently has good credentials.
We could find ourselves up against the anti alternative medicine
lobby which is well funded and well organised. It has forced through
legislation to restrict the sale of supplements, and is triumphant about
the closure of homeopathic hospitals. They will work to discredit this
register and everyone on it, and by associating ourselves with
therapists we could harm the reputation of the Alexander Technique which
in the main has escaped such criticism.
In
order to function, the register needs 10,000 to sign up – as far as I
can determine they only have around 300 so no wonder they are getting
desperate. To compound their problems, the registrar appears to have
departed after only one month in post. (Note
2)
A Popular Misconception: ~
“Regulation will stop physiotherapists and yoga teachers
from claiming to be Alexander Teachers”
Physiotherapists have a registered title and are registered
with the HPC (Health Professions Council) which is for mainstream
practitioners such as chiropodists. I have not seen anything to suggest
that registration with CNHC will confer a protected title. Even if it
did there are variations that can be used to get around it eg Alexander
Practitioner, Teacher of the Alexander Method, Alexander Therapist
(hopefully not!) etc.
Alexander Teachers, however well qualified (or not), are free to
practice without being regulated. There are plenty of teachers out there
who are not members of any organisation who just quietly get on with it.
Individual professional indemnity insurance costs under fifty pounds,
with no CPD, no CRB, no NOS, no STAT fee, and no hassle. And you can
still refer to your pupils as pupils not learners! There is nothing in
the proposed regulatory system to prevent this, and even if there was it
would be easy to get around.
Even the term Registered Alexander Teacher will be pretty
meaningless. Most therapists are on some sort of register and are
therefore registered. So if anyone on a register can call themselves a
‘Registered Alexander Teacher’, we have gone to a lot of trouble to
get back to where we started. And there is a possible plan to create a
Register of Independent Alexander
Teachers; for teachers not prepared to be associated with the lower
training standards of the other bodies, and who chose not to be in STAT.
The problem of ITM and the
future of STAT
One problem has been that the larger groups have to accept the
training standards of the smaller ones, leading to a lowest common
denominator situation. One aim of regulation is to ensure minimum
standards, and sadly, that is exactly what it will deliver. A stated aim
of regulation is to prevent inadequately trained teachers from gaining
access to the register – what do we
mean by ‘inadequately trained’?
Not many STAT teachers I have spoken to are happy to sharing a
register with ITM, and there is another problem: ITM courses are one
weekend a month, and not surprisingly are attracting recruits. Several
STAT teachers have said to me that the ITM course costs about the same
as ours, but it doesn’t, because to train on a STAT course you have to
give up your day job. For a physiotherapist that’s a loss of earnings
of up to £100,000 on top of the training cost. Other therapists may
want to train as Alexander Teachers, and a
one-weekend-a-month-and-keep-your-day-job course is going to look a lot
more attractive because in the end you get a certificate that enables
you to go on the same Register for a lot less commitment, time, and
money. ITM is already growing fast; the
Bristol
course has been recognised by
Bristol
University
and has more trainees than the STAT course. ITM websites are unabashed
in informing visitors about the results of the back pain trial, even
though they had nothing to do with it, and, we should note that STAT
members who also represent ITM are strongly in favour of regulation.
Factor in that if we do go ahead some teachers will leave STAT
(there are well advanced plans to set up other societies, and some heads
of training are seriously considering joining them), and others will
simply leave and go it alone. Whilst ITM continues its rapid growth,
STAT may start to shrink. We are the largest representative body, but
for how much longer? We need to wake up!
Working in the NHS
Some teachers are very keen and are raring to go, whist others
are critical saying that giving six session tasters on the NHS to try to
cure back pain gives a wrong impression of our work. I’ve heard
teachers in favour describe signing up to the NOS as a necessary evil,
and those against say that it is irrelevant, absurd, and harmful to our
profession. The whole regulation debate seems to focus on whether the
teachers who don’t want to work in the NHS should compromise their
principles for the benefit of those who do. Teachers I have spoken to
who have worked in the NHS as medical staff say they wouldn’t go
anywhere near it.
Acupuncture has been available within the NHS for many years,
mainly in pain clinics. However most acupuncture in the NHS has been
taken over by doctors. An acupuncture training is a four year study of
Integrated Chinese Medicine, the standards of which are very high.
Unless of course you are a doctor, in which case its 24 hours over a
couple of weekends. It is not inconceivable that doctors will think AT
looks like pretty simple stuff and will do the same thing, and we
won’t be able to do anything about it.
Some physios already ‘teach Alexander Technique’ and I can’t
see that joining the register will make any difference, and may make the
problem worse.
So what happens if we
don’t sign up?
No one knows. One reason for going along with voluntary
regulation is the fear that if we don’t, then the government will
regulate us, and this should be taken seriously. But fear is never a
good motivation for making a decision. Who will regulate us – the same
government that made such a success of regulating the bankers, the
financial services industry and its own MP’s? We could try resisting
outside interference. We regulate ourselves very well, and legislation
to regulate something as nebulous as the Technique would be difficult,
and costly, and the government hasn’t got a lot of spare change at the
moment. And in a years time we are likely to have a different government
who may not be quite so obsessed with controlling everything and
everyone, and would be more willing to let us get on with it.
And although this question has been asked before, why have we
allowed ourselves to be categorised with therapists? Personal trainers
work one to one, make physical contact, and there are health benefits
resulting from their work, No one is suggesting that they are
therapists. What about music teachers, and sports coaches, surfing
instructors and the like? They just get on with it and are generally
left alone, so how did we get ourselves into this mess?
There are arguments for and against voluntary regulation, but I
believe that it is the (currently) smaller groups like ITM who have the
most to gain, and we who have most to lose. I’ve heard regulation
described as a Trojan horse to get recognition for ITM – no wonder
they are so keen.
I would like to finish by saying that this is not in any way
intended to be a criticism of council or any individual associated with
the regulation process, and I have nothing but admiration for those who
have worked so hard over the years to initiate a process that on the
surface appeared to have a lot going for it. My intention has been to
look under the carpet to see what might have been swept underneath or
pick up points that may have been overlooked, and I hope that my
ramblings will stimulate further debate.
Mike Rawlinson
Note 1
Most alternative therapists and many Alexander Teachers
will not join the register, and we can expect statements like the
following example to appear on therapist’s websites. How will this
reflect on us if we are on the register?
“We have chosen not to sign up to the CNHC register (commonly
known as Ofquack), as we believe that the training and competence
standards set by CNHC to be far too low and inappropriate to our
profession. We believe that this has led to a lowering of professional
standards and do not wish to be associated with a register which in our
view contains therapists who are inadequately trained, and whose work
does not meet the standards of our profession.”
Or
“The Alexander Technique is not a therapy and as a Teacher of
the Alexander Technique, I have chosen not to join the register of
Alternative Therapists (Ofquack) as it is not appropriate to the work I
do. The standards for inclusion on the register are minimal, and below
what I would consider appropriate for a professional practitioner.
Details of my training and qualifications, training and experience
follow, and these far exceed the requirements of the Register.”
Note 2
The current estimate of members is around 4000
Mike Rawlinson June 2009
Recent News
Latest News on 'Voluntary'
Regulation
According to a press
release dated 1st April from the Department of Health Next
steps for complementary therapy, practitioners of herbalism,
acupuncture, and Chinese Medicine, (after waiting several years for the
government to come up with the statutory regulation they need and were
promised), are now to be compelled to register with
the CNHC. The reasons are probably political as this will save the
government from having to bother to go ahead with statutory regulation
for these therapies, and will ensure a huge increase in members and a
corresponding increase in income for the CNHC. thus saving the government
from having to bail it out.
From the point of view
of the CNHC this is excellent news because compelling some therapies to
register is the first step to compulsory regulation for all of us. And
as if this was not bad enough, herbalists have been told "off the
record" that voluntary regulation will eventually be compulsory.
Which is interesting because they told us that regulation was voluntary
and we could withdraw at any time. It seems that the CNHC will say
anything to anyone to get them to sign up - Can we trust anything the
CNHC says?
Fortunately early
indications are that no one is falling for that one!
A
few years ago, clinical trials established that Cognitive Behavioral Therapy (CBT)
was effective in treating depression, and it became available on the
NHS. Not surprisingly the NHS uses therapists
trained on short courses, and as if this wasn't bad enough, NICE (The National Institute for Clinical Excellence)
now
recommends dispensing with therapists altogether and delivering
cognitive behavioral therapy for depression by computer in place of a
therapist! You can read the full story in The
Independent.
A
few years ago, clinical trials established that The Alexander Technique
was effective in treating low back pain..........
Alexander Teachers Rush to Join CNHC
Register (but not from STAT)
The
register currently has 63 'Alexander Teachers' on its register, but only
22 are STAT members. The other two
thirds are from ITM or
PAAT, neither of which has the full-time training standards that STAT
requires for its members.
Of
the 22 STAT members on the register, over half are on council or closely involved with regulation prior to the debate.
So why did we go
through all this hassle?
Government Plans to Regulate
Psychotherapists and Councilors
After three years of
consultations the government (through the HPA) have published their Draft
Standards of Proficiency for Psychotherapy and Counseling. Note the relevance
of these standards
The Standards dictate that
practitioners should:
- know how to operate equipment and minimise the risk of infection.
- know how to select appropriate hazard control and risk management,
reduction or elimination techniques.
- have a knowledge of health, disease, disorder and dysfunction.
- be able to evaluate and implement intervention plans using recognised
outcome measures.
- know how to use protective equipment.
- know how to formulate and deliver plans and strategies for meeting health
and social care needs.
- understand the principles of quality control and quality assurance and
conduct audits correspondingly.
- maintain an effective audit trail, participate in audit procedures and
work towards continued improvement.
- be able to formulate specific and appropriate management plans
including the setting of timescales.
- demonstrate a logical and systematic approach to problem solving and be
able to initiate problem solving techniques.
- observe and record client's responses.
-be able to demonstrate effective and appropriate skills in communicating
information, advice and instruction.
- understand the need to engage service users and carers in planning and
evaluating the diagnostics, treatment and interventions to meet their needs
and goals.
And just in case you find this
hard to believe, here is the link
Quite apart from the fact that
much of it is meaningless waffle, non of it is remotely relevant to the work
done by psychotherapists. Do we really want to get ourselves mixed
up in this kind of nonsense?
What The papers Say
Well very little
actually. The CNHC issues regular press releases that they publish on
their website but we are not aware of any newspaper ever having
published any of them. We have searched the on line editions of all
major newspapers for any mention at all of the CNHC: the Independent
hasn’t mentioned it, nor has the Daily Mail, and neither has the
Telegraph. The Times gives it the briefest mention at the end of an
article about medical misconduct, and it is left to the Guardian (a
newspaper that recently printed a very positive feature about ex STAT
head of training Jeanne Day) to give the public the facts about the CNHC.
Which it does in a lengthy and utterly scathing article titled
False Assurances
"The complementary and Natural
Healthcare Council's claims to regulate alternative medicine are
misleading and dangerous"
And it continues............
‘The
history of the CNHC reads like that of a government body in a banana
republic….Is all this then just a farce, a waste of money and an
exercise to please Prince Charles? No, I'm afraid it is worse than that.
……the CNHC, probably for the first time in the history of the NHS,
firmly establishes double standards in British medicine.’
Anything
on the telly? Not yet, and if radio is anything to go by it won’t be
very positive either – have a listen to this podcast. Move the slider along
to 20 minutes if you don’t want to listen to the Richard Dawkins
interview
None of this should
surprise anyone. Any mention of alternative medicine and Prince Charles
in the mainstream media is almost universally derisory.
So why have we exposed
ourselves to this kind of ridicule?
Voluntary Registration?
Of course we can all be
assured that registration with the CNHC is voluntary, but voluntary can
mean different things to different people. Here is what Maggie Dunn,
Chair of the CNHC said in a BBC interview under the heading
'The head of the
UK's first regulator for complementary medicine has promised to get
tough with the industry'
"As applying to the register is
voluntary, Ms Dunn accepted that some therapists might not put
themselves forward. But she said they would be found out in the end as
"within a year or so" customers will be looking to only use
therapists who have met the regulator's standards."
So those of us who
don't sign up will be 'found out' by Ofquack!
This isn't quite what
some of us understand by voluntary, and since when were we part of an
industry, and how will the CNHC 'get tough' with us, and what will
happen when we are 'found out'?
(Oh and could someone
teach Ms Dunn the whispered ah therapy?)
Government Backs Down on
Statutory Regulation
This item will be soon updated in line with the piece
at the top of the page
For over ten years the
government has been preparing the way for statutory regulation of
practitioners of Chinese medicine and medicinal herbalists. Just as it
was about to come into force the government changed its mind and put
everything on hold - it's just not a priority at the moment. The
professions concerned are desperate to be regulated as their situation
is that if they are not, they won't be able to practice. Regulation is
not going to win any votes and it just isn't that important anymore.
As far as we are
concerned this indicates that no one is gong to force us into regulation
and that the fear of enforced regulation is not a reason for going along
with the CNHC
So why did we get
ourselves involved with the CNHC?
"As applying to the register is
voluntary, Ms Dunn accepted that some therapists might not put
themselves forward. But she said they would be found out in the end as
"within a year or so" customers will be looking to only use
therapists who have met the regulator's standards."