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Trusting the Professionals

March 4, 2010

Trusting the Professionals With a wealth of top institutions and companies based in my seat, many of the people I speak to through my constituency work are leading professionals in their fields with unparalleled industry knowledge. Their insights as to the practical application of policy are invaluable to me.

One of the most striking things to come out of my meetings in recent months is the sense of demoralisation amongst those involved in vocational work. The unease is so deep that I am convinced that should we win office, we must set about fundamentally realigning the relationship between government and professionals.

While working in a variety of fields, the message of many experienced practitioners is eerily similar: ‘Who will be sufficiently committed and experienced to fill our shoes when we retire?’ This is not, as far as I can tell, the lament of those unable to accept the passing of the baton to a younger professional generation. Instead it is borne of a real sense of fear for the welfare of clients and the value of their profession following the erosion of trust in their workplace.

I am told most senior NHS hospital consultants, for instance, are heartily sick of the way their profession has developed. The NHS seems to be at a tipping point with its target-based obsession and in the words of one constituent, ‘If we continue to treat consultants like automatons on an assembly line, that is how they will end up behaving’. The problem in this case seems in part to stem from the Labour government’s imposition almost a decade ago of a consultants’ contracts system. Presented to the press as a sure-fire way of ensuring that ‘consultants did not spend their time on the golf course’, it institutionalised a clock-watching culture at odds with professional ethics. The perverse consequence was to turn medical practitioners into piece workers, with the scrutiny of a clocking-in system removing the sense of vocation and trust in a group of people who were used to staying until the work was done, irrespective of notional working hours.

Another constituent, a leading obstetrician, described to me how in recent years he has had to cancel clinical work as a result of compulsory attendance on ‘essential’ courses he has been mandated to attend by the consultants’ contract. These were rarely courses designed for his professional development but invariably workshops to ‘educate’ him in bereavement management, bullying, ethnic diversity and so on. My constituent felt the entire vocational ethos was being drummed out of medical practitioners by excessive management diktat. From my contact with many of his contemporaries there is a growing belief that as their generation retires, it will be replaced by a cohort that considers itself more a public sector workforce than professionals exercising judgement.

I had a similar conversation with a highly qualified psychotherapist who wished to get off his chest very deep concerns with the government’s mental health strategy. He described how he and his colleagues had all chosen to work outside the NHS because they did not want their professional judgement constantly questioned. They preferred too to be regulated by their own professional body rather than some overarching, dictatorial quango.

Psychiatrists in the health system, he believed, were there merely to administer drugs, doping patients into submission rather than dealing with their underlying psychological problems. This in part stemmed from a fear of making decisions which could later be called into question by a patient making a malicious complaint against the NHS. In his frustration, he went so far as to suggest that we should ban the lodging of complaints against free, state-provided services, such are the restrictions placed upon professionals by the pernicious litigious culture that has developed in tandem with the expansion of the welfare state.

A meeting I had with a team of leading criminal lawyers was equally disheartening. Their particular gripe lay with the Legal Services Commission, a classic New Labour quango set up in 1999 to replace the Legal Aid Board. While it takes on the powers of the Law Society, it also expands the ‘access, diversity and equality’ agenda in the legal profession. Until its abolition the Legal Aid Board had a staff of 200 nationwide. That number now stands at 1700 and its budget of £160 million has risen by 10% in each of the last three years, economic recession notwithstanding. While expanding this vast quango, the government has simultaneously constricted the legal aid budget, essentially choosing to ‘invest’ in diversity officers over lawyers representing the most vulnerable in our communities. I am forced to ask why any lawyer would now choose to devote any of their time to legal aid work.

There is no doubt that teachers, policemen and many other workers in vocational careers share these frustrations. Public sector professionals, along with those in publicly-regulated private fields, have been emasculated. Trust in them has been stripped away and handed straight to unaccountable bodies and middle managers, however well meaning. Too much of their time and energy has been expended in diversity agendas, making them footsoldiers of central government’s social engineering projects. We have tied them up in endless box ticking and we have deadened their capacity to make decisions through fear of malicious litigation.

The warning signs about the future of the professions could not be clearer. It is time for them to wrest power back.