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I've made public my letter to the HPC regarding the position I have taken in respect of podiatry regulation under the Health Professions Order 2001. It is no secret that I deregistered in 2008 and continue to use the title which is protected under the legislation - and this explains my reason and objectives in doing so. This is my decision and I don't expect you to support or agree with it before anyone starts rattling their sabres!
Dear === ====
Thank you for your letter dated xxxxxxx regarding misuse of title, which follows our correspondence last year culminating with my letter to you of xxxxxx which I set out my position regarding same. I would like to reiterate my stance to you once again in the hope that we might resolve the various issues that I have highlighted to you since I lapsed my registration in August 2008.
Firstly, I would like to state that I am not opposed to regulation of my profession, nor do I suggest that the HPC is an ineffectual regulator. The primary function of regulation is to protect the public and to do so, the regulator has to act within the constraints of the legislation – the Health Professions Order (HPO) 2001. It is, however, my contention that it is the legislation which is ineffectual, at least in relation to the podiatric profession, and as such, the primary function of protecting the public is seriously impaired.
The podiatry profession is particularly unique in the various health professions which you regulate insofar as the majority of registrants practise within the private health market as opposed to within the National Health Service. Training for podiatry is conducted through accredited and recognised Schools of Podiatry. However there has always been an unregulated sector in the private market both in practice and training and whilst one of the aims of the HPO was to bring all the various sectors under the regulatory umbrella – via the grand-parenting program – in relation to the podiatric profession, it has failed in its objective. Primarily this was due to defective legislation which has allowed private trainers and practitioners to circumvent the legislation by using alternate titles – other than chiropody or podiatry. For example – Foot Health Practitioner or Podologist – the latter being the standard European term for podiatrist.
Protection of title within the professional landscape is meaningless unless there is clear definition and protection of function within that profession.
For example; xxx xxxxx is a HPC registered podiatrist in private practice who is found to be grossly unsafe by a FTP panel following a complaint and is struck off the HPC register. Immediately following the hearing, xxx xxxxx changes her business stationary and advertising listings and promotes herself as a Podologist or FHP. She can still practice exactly the same as before, but now unregulated and without restriction. She may have been removed from the register, yet there is no effective protection for the public who are still at serious risk from this practitioner.
In addition to this deficiency in the legislation, there are other aspects of the HPO that I consider detrimental to the public interest. I believe the regulator has been given insufficient powers to deal with malicious and/or vexatious complainants, who, for whatever reason, seek to use the regulatory framework to damage the reputation and livelihood of registrants. I fully accept the need to investigate any complaint made against a health professional; however, where the complaint has been found to have been vexatious, malicious or unfounded, the regulator has no powers to prosecute the complainant, other than to report the case to police. Where such complaints have led to practice suspension orders being imposed, the registrant has no legal redress when there has been no case to answer. If that registrant is self-employed, such an order may lead to considerable loss of income and closure of business which may be catastrophic for that individual’s practice. Such an outcome is not in the public interest.
I refer to my own experience when a compliant was made against myself and where the complainant was a fellow registrant. Three separate NHS investigations undertaken prior to the complaint being made to the HPC found the allegations to be malicious, vexatious and without foundation. Whilst the FTP Panel properly carried out a twelve-month investigation and found there was no case to answer, they had insufficient powers under the HPO to take action against the complainant. Where there are no inhibitory mechanisms to deter malicious and unfounded complaints, the FTP process is open to abuse. In these cases, I would like to see additional powers to be given to the regulator to:
(i) Table prosecution through the Crown Prosecution Service (CPS) and
(ii) To award compensation to cover loss in the event of a malicious and unfounded complaint being made.
I have been in practice as a podiatrist for almost thirty years and I would like to think I have been a good advocate for my profession both in terms of patient care and representation in the wider community – both local and national. I have been – and still am – extremely passionate about my vocation and I strive to provide the patients under my care with the very best clinical and professional attention that they deserve. I abhor poor practice and I am dismayed by the divisions within my profession that have existed throughout my professional career and very much regret the inadequacies of the HPO in addressing these deficiencies – to the detriment of the public and profession alike.
I have lobbied Parliamentarians and Ministers but I detect no desire to amend the legislation to address these inadequacies, therefore I have come to the conclusion that the only way to achieve effective regulation is to defy the regulation by deregistering and maintaining the use of the title that I have used for the past 29 years. To that end I would welcome prosecution to clarify this argument as I feel that this is the only way left to me to achieve the principal aim – that of effective regulation to protect the public.
Fully understand your course of action Mark. In cases outside of the HPC, if a complainant makes false and spurious allegations against an innocent victim, what action can be taken against the allegator?
__________________
“Body: A thing of shreds and patches, borrowed unequally from good and bad ancestors and a misfit from the start”
didn't know if allegator was a word, but legally, what recourse would you have for e.g. I maliciously and falsely accused you of theft, shafted your reputation and dragged you through the courts?
__________________
“Body: A thing of shreds and patches, borrowed unequally from good and bad ancestors and a misfit from the start”
Very brave of you. I hope they take notice and act upon it. I am dismayed that people who have only completed 2 weeks practical experience can be let loose on the public with a scalpel and call themselves professionals with fancy letters after their name. The general public often have no idea of the difference between a FHP, podologist or podiatrist. I think beauty therapists have much more training doing pedicures yet they are not allowed to use a scalpel. I often wonder what will happen in the future and it makes me worry about podiatrists. Will it be GPS for nail surgery, FHPs for nail cuts, physios for msk, orthopeadic surgeons for surgery and nurses for wound care and diabetes? I agree we have to fight for our profession and not let FHPs take away our work. I think it's outrageous that FHPs can do absoloutely anything to the foot and get away with it as there is no one regulating them. Let us know how you get on with your campaign. It sounds like you have been through the mill with it all and hope things improve.
It seems that if you are prosecuted, there will be lots of other pods coming forward to support your case. It is ridiculous that after so many years coming, the regulation is totally useless, a waste of time, money and resources.
Perhaps all the regulated pods should leave the HPC on mass and come up with a different title for what we do?
But do we have the courage?
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Did you know that you can be struck off from being a chiropodist/podiatrist one day, and set up calling yourself a FHP/Foot health specialist and that is legal.
How the f*** is that protecting the public? it isn't!
the legislation ia nothing short of a complete shambles.
Did you know that you can be struck off from being a chiropodist/podiatrist one day, and set up calling yourself a FHP/Foot health specialist and that is legal.
How the f*** is that protecting the public? it isn't!
the legislation ia nothing short of a complete shambles.
Exactly, that's my point!
If all the registered pods left the HPC en-masse and called themselves by another name, in protest, it would show the ridiculousness of the legislation and perhaps draw the publics attention to this very regrettable situation.
It seems that if you are prosecuted, there will be lots of other pods coming forward to support your case. It is ridiculous that after so many years coming, the regulation is totally useless, a waste of time, money and resources.
Perhaps all the regulated pods should leave the HPC on mass and come up with a different title for what we do?
But do we have the courage?
In short. The HPC offers no protection to the public, just a stick to beat paid members with.
I remain with the other 'sheep' . Too afraid for my livlihood & future mortgage payments to oppose that which I find pointless. I continue to pay each year to this (HPC) & other (whose name I dare not speak) for fear of retribution & loss of all I have worked for.
Just 6 winning numbers away from saying: Stuff this!
Apathetic & not a little p155ed off with all the pointless posturing.
All credit to Mark who has the courage to speak & follow his true thoughts.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
I think if a significant number deregistered - and I don't know what a significant number could be - then it would certainly force the issue - and if backed by a public campaign, then perhaps there would be a political appetite for change. After all it's a no-brainer really if the call is from the profession to tighten and close loopholes in the present Order. Personally, I cannot understand why the various representative bodies haven't lobbied their members to ask what they think should be done. And I don't see why any deregistered clinician shouldn't continue to use the title they earned quite properly through qualification. Why should their livelihood be threatened because they consider the current regulation to be detrimental to public safety because of the exploitation and circumvention of the legislative weaknesses?
I don't consider the possibility of prosecution a threat; I welcome it if it allows the opportunity of putting the case to jury or legal panel and I would be reasonably confident of influencing the argument positively. But I don't wish to start a movement or anything like - I'm just doing what I think is right. End of.
1. I understand all that has been expressed above.
2. I certainly don't support the concept of better the devil you know than the one you don't.
That said it may well be the case that the ideals that people would like to see in a different or altered professional organisation quickly become neutered in the scheme of things. Change has never been a thing of worry for me but as I age I am more cynical that what we may want and what we end up getting can be quite different.
Not a reason to not act but a reason to act realistically and not ideally. Not that you are of that ilk yourself.
I really enjoyed ringing the HPC back in October to dereigister before emigrating to NZ, although they still tried to convince me to stay registered - as it's all about the money and protecting their phoney baloney jobs. Good luck to you Mark, however the HPC will continue to become an all consuming corperate empire building monster. How did we cope without them?
Just a short update on the above. I received a letter on 14 May from Bircham Dyson Bell - agents for the HPC. This and my response follows.
Quote:
Dear Sir
We act for the HPC the statutory regulator for chiropodists and podiatrists.
The HPC has received complaints from the public to the effect that you are misusing the title “Chiropodist” and describing you in correspondence as a “Chiropodist and Specialist in Podiatric Medicine”.
The HPC records show that you are not registered as a chiropodist, your registration having lapsed on 1 August 2008. The HPC has written to you explaining the only circumstances in which you would be entitled to use the term “chiropodist” is if you are registered with the HPC. This applies regardless of whether you hold relevant qualifications or have been registered with the HPC in the past. In your letter to the HPC on 18 April you confirmed that it was your intention to continue with the use of the title “chiropodist”.
Article 39 of the HPO 2001 make it a criminal offence for a person, with intent to deceive, whether expressly or by implication, to misuse the title “chiropodist” or any other protected by that Order.
Offences under the 2001 Order are triable in the Magistrates Court. Unless you confirm to us within the next 14 days that you will cease to use the title “chiropodist” or any associated title, criminal proceedings may be commenced against you without further notice.
Yours faithfully
Bircham Dyson Bell
Quote:
12 June 2012
Dear
Thank you for your letter of 14 May 2012 and for your telephone call the other day. I appreciate you taking the time to do both. I presume you have been given the correspondence file with the instructions from your client in relation to the Protection of Title claim which will contain my letter to the regulator when I served notice of my deregistration and the grounds for doing so in July 2008 and the subsequent correspondence surrounding this issue. Clearly you will need to determine whether to proceed to litigation. In doing so, you may wish to consider the following.
I am not against regulation of my profession. It is a necessary part of the fabric of the professional practice landscape and it should serve to protect the public whilst giving the registrant clear guidelines in which to practice. For regulation to function correctly, it has to be effective and it is my contention that the Health Professions Order 2001 to which you refer, is clearly deficient and in need of amendment. The HPC only regulates those practitioners who subscribe to the use of a protected title. If practitioners do not wish to be regulated they simply practice under another unregulated title. In my profession that could include – podologist (the accepted European title), Foot Care Specialist, Foot Health Practitioner, Foot and Ankle Specialist – ad nauseum. If a regulated practitioner is prosecuted under the Fitness to Practice process and is found to be a clear danger to the public, there is no process in law to prevent this individual from continuing in practice and endangering the public, doing so without any restrictions after being struck off the register – providing they adopt the use of an unregulated title. There is a clear deficiency here in the function of protecting the public, as I am sure you will agree.
There is a secondary issue you may wish to consider, but I would like to make it clear that this is not the primary reason for my position. I think a hearing would also have to consider the influence of the Human Rights Legislation in relation to a claim of protection of title. I have been in practice now for almost thirty years and I would like to think the standard of my care is as good as any in my profession. The interests of my patients are and have always been paramount. Given the circumstances and my position as set out above, I think a court may take the view that it is my human rights and those of my colleagues and the public at large that are being infringed and endangered by the present legislation and I suggest that may also be a factor in your deliberations.
I did not take the decision to deregister lightly as these things always take up a considerable amount of time and effort, but I do think in this case it is worth doing so. Please be advised that I have never sought to deceive my patients or colleagues – my position is well known – nor the regulator as to the continued use of the titles you mention.
The “complaint” to which you refer has come from the owner of a clinic where I used to practice until early this year. I – along with many of my colleagues – left when the complainant encountered financial problems and after several bounced cheques for reimbursement of patient fees and the theft of money from one of my accounts I considered I could no longer practice there. The complainant was fully aware of my position in 2008 and it would appear any subsequent complaint to the HPC is being made to offset a civil claim for repayment of monies and damages that may be made against him. I am very happy to answer any question you may have in relation to this.
I am also very happy to proceed to litigation as I am afraid I cannot comply to your request for compliance. It would appear to be the only way that offers any possibility of amending the legislation that governs regulation and I look forward to hearing from you in due course as to how you wish to proceed.
I de-registered in November last year, a very warm feeling indeed. Alas I have left the country to practice in New Zealand, where a podiatrist is a podiatrist. On the downside though our professional fees give me sleepless nights (as well as the earthquakes).
Best of British to you and I'll be watching with interest.
Mark
Christchurch
NZ.
Thanks Mark and good luck. I nearly bought a practice in Blenhiem about 25 years ago but unfortunately it was sold before an offer could be made - it looked a fabulous place to live and work. Hope things work out well for you and you get plenty opportunities to explore these islands intimately. Keep us posted!
Just a sort update to report, unfortunately, little progress. It's now over five months since I last had communication on this matter from the HCPC's solicitors and a phone call to them today reveals they are still awaiting their client's instructions. Been a long deliberation. I understand those in the know at the HCPC read these forums from time to time. Anyone care to offer any advice??
The ins & outs of the efficacy of the HPC is surely irrelevant to any defence you may make in an action for an offence under the 2001 Act. A court action may well provide a stage for you to voice your opinions on the appropriatness of the Act but any half competent barrister will easily deflect your aim.
Surely your hope lies in the fact that not only do you have a chiropodial qualification recognised by statute but had also been using that qualification for a number of years prior to the start of the Act.
A court may well decide that a retrospective disenfranchisement breached your human rights !
I received my papers from the HCPC last week regarding my misuse of title. For legal reasons, I am unable to furnish you with the prosecution details at this stage, however, my initial hearing will be at Westminster Magistrates Court later in May for pleading and legal arguments. When I have my trial date, I will let you know the details.
The basis of my case is fairly well known by now and will be familiar to most of you. If you have an opinion regarding regulation of podiatry with respect to protection of title -v- function and the loopholes that are currently being exploited, I would like to hear from you - and if relevant, I may lodge this as supplementary evidence during the proceedings. I remain most grateful for your kind words of encouragement and if you feel you might like to add some weight to the argument, please PM me and I shall give you my contact details.
I too think Mark shows great courage making a stand. He has my admiration & I wish him every success both in this pending case & the future. His actions may be just what podiatry needs. Someone with the balls to put their money where their mouth is rather than anonymously whining about fhps etc.
Mandy.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
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I too think Mark shows great courage making a stand. He has my admiration & I wish him every success both in this pending case & the future. His actions may be just what podiatry needs. Someone with the balls to put their money where their mouth is rather than anonymously whining about fhps etc.
"Firstly, I would like to state that I am not opposed to regulation of my profession, nor do I suggest that the HPC is an ineffectual regulator. The primary function of regulation is to protect the public and to do so, the regulator has to act within the constraints of the legislation – the Health Professions Order (HPO) 2001. It is, however, my contention that it is the legislation which is ineffectual, at least in relation to the podiatric profession, and as such, the primary function of protecting the public is seriously impaired."
IMO this is the best point of Mark's letter! It hits the nail bang on the head!
The podiatry profession is particularly unique in the various health professions which you regulate insofar as the majority of registrants practise within the private health market as opposed to within the National Health Service. Training for podiatry is conducted through accredited and recognised Schools of Podiatry. However there has always been an unregulated sector in the private market both in practice and training and whilst one of the aims of the HPO was to bring all the various sectors under the regulatory umbrella – via the grand-parenting program – in relation to the podiatric profession, it has failed in its objective. Primarily this was due to defective legislation which has allowed private trainers and practitioners to circumvent the legislation by using alternate titles – other than chiropody or podiatry. For example – Foot Health Practitioner or Podologist – the latter being the standard European term for podiatrist.
Protection of title within the professional landscape is meaningless unless there is clear definition and protection of function within that profession.
For example; xxx xxxxx is a HPC registered podiatrist in private practice who is found to be grossly unsafe by a FTP panel following a complaint and is struck off the HPC register. Immediately following the hearing, xxx xxxxx changes her business stationary and advertising listings and promotes herself as a Podologist or FHP. She can still practice exactly the same as before, but now unregulated and without restriction. She may have been removed from the register, yet there is no effective protection for the public who are still at serious risk from this practitioner."
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Can I first just say thank you to all those who have written in support and with kind wishes, both through Pod Arena and by email. It has been quite a humbling experience and I am most grateful for your consideration.
With regard to the function of the regulator, an interesting snippet from the prosecution papers as it now seems the primary duty of the HCPC is not to protect the public after all but "to protect those members of the public who seek care from those we regulate." That should make for an interesting argument!
I believe that we all know that the HCPC is totally inefficient in it's role. Good luck Mark, I wish you well in your case. I only wish I had the courage and money to do the same as you.
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Just to be clear regarding the issues surrounding this case. The principal aim is to effect an amendment to the primary legislation - the HPO 2001 - and to change the procedural process in FtP hearings. Taking the last first - I am unhappy regarding the process surrounding complaints made against registrants which are found to be vexatious, malicious, fictitious and without foundation. There needs to be a clear definition to what constitutes a legitimate complaint from one that is intended to be injurious or harmful to the practice of the registrant. The HCPC is granted the powers of prosecution by statute - criminal proceedings for Protection of Title matters and civil/disciplinary proceedings for FtP cases. Malicious allegations in the former would constitute a contempt of process and as it is a criminal matter, the court - and police would have the powers to instigate proceedings against the complainant, especially if they have falsified evidence against the registrant. In civil or FtP cases, the HPC have no powers to act against a complaint when a complaint has been found to be vexatious, malicious etc.
Given the detrimental effect such cases can have on the livelihood of a registrant - especially those in private practice (which is the majority of this profession) it is clear that the regulator needs additional powers to effect redress in such circumstances. What powers of sanction - fines etc - is a matter for government and its legislators, but I do think it would be helpful to grant these powers, if for no other reason than to inhibit or deter vindictive complaints which have no basis in fact. This will require an amendment to the primary legislation, however I would also like the HCPC to consider their process in dealing with such complaints and the practice of advertising the allegations on their website before the hearings have taken place.
The other issue is, of course, POT and in particular the misuse of title. As Bill, John and others have alluded to, there is the Human Rights Act and the right to work. My own case is different insofar as I have voluntary given up the right to use the title HPC Registered..... but maintain the use of the title I have always used - Podiatrist. This is not the thrust of my action - I think the vast majority of you know and understand the reasons behind my position, which is the circumvention of the legislation by people who pose a real risk to the public - those who have been found to be unfit to practice by the regulator as well as those who have no formally recognised training or qualifications.
As stated previously, I have nothing against the HCPC - I have always found them to be courteous and helpful with all my dealings with them. The problem is with the primary legislation and the overarching regulation - one size fits all approach - which has not served any of the professions, but especially our own, very well since its introduction. And it certainly doesn't protect the public - which is why it was introduced in the first place.
Mark, as I said previously; Surely your hope lies in the fact that not only do you have a chiropodial qualification recognised by statute but had also been using that qualification for a number of years prior to the start of the Act.
A court may well decide that a retrospective disenfranchisement breached your human rights !
__________________
John Mason
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I have just sited your page on Regulation of Podiatry.
Having taken a similar stance with the HCPC and the Health Minister. I would appreciate an update on how you are progressing.
I have acquired a very good legal team should you require further support. http://www.podiatry-arena.com/images/smilies/boxing.gif
Best Wishes
Mark
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Regulation of Podiatry
Re: Regulation of Podiatry
Yep. What she says.
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