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.
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As has already been referred to, I went to see the noble Baroness, Lady Hayman, who was Health Minister in the Lords, in 1999. She agreed, saying, “Yes, there is a serious problem; will you try to do something about it?” I did: I got together with all the psychotherapy organisations and we eventually brought forward a Bill, with their agreement, in the early 2000s—two Bills in fact. The Government did not follow either of them, although the second went through your Lordships’ House.
This is not a recent problem, but it is getting worse for a whole series of reasons. If the Government argue that this is not the Bill, I do not think that is valid: it is the Bill that can address it, at least for the victims of domestic abuse. I think that the Government are bound to let us know when and how they intend to bring in the registration of psychotherapy for the protection of clients and patients, and vulnerable therapists, who themselves are working outside the health service and do not have the protection that they need in these difficult times. I look forward to what the Minister has to say, and I hope that he will be able to go further than Governments have gone in 50 years of failure to follow up on the report that they themselves commissioned in 1971.