I am beginning to understand the reluctance of some in this mailbase
community, to entertain or participate in debate where the subject matter
is fundamentally political and/or strategic in nature. This month’s
discussion over grandparented practitioners highlights the advantages and
disadvantages of online forums as a means of conducting argument. One
positive aspect, for me at least, was the momentum by which the argument
developed. Over the space of a weekend there were over one hundred
contributions to a single subject and whilst the value of some of these
submissions were undoubtedly limited (and I include some of my own here),
many valuable developments were opened up by the willingness of
participants to contribute in a positive manner. This doesn’t mean the
debate was conducted without passion or that there was no anger on
display. That would render the process sterile. Yet, I suspect it was the
presence of these two emotions that ultimately led to demise of the
discussion and the retreat of the respective parties to the safety of
their established and entrenched positions once again.

Why does passion and anger elicit such a response? Consider the example of
anger.

Aristotle saw it as an emotion capable of great power and good effect if
wisely directed. ‘It is easy to fly into a passionate rage,’ he
remarked, ‘anyone can do that; but to be angry with the right person, to
the right extent, at the right time, in the right way, with the right aim;
that is not easy.’ He thought that knowing how to be appropriately angry
is an essential part of moral life, providing that it does not depose
reason and thus becomes destructive in consequence.

I think there is a lesson in this for many who contribute on these forums.
It is easy to become entrenched in a particular mindset when passion or
anger is directed towards us. When that occurs, our natural reaction is to
become defensive or even obstructive. This has the effect of stagnating
the dialogue and the momentum is quickly lost. Contributors thus become
frustrated and irritated and when or if they are minded to reply, the
debate quickly degenerates into insult and farce. This is a great shame
for emotive, reasoned argument can produce great results and in a medium,
like the Internet, they can be achieved in a remarkably short period of
time.

Consider the debate this month. Within a period of two weeks, we
highlighted the problem of membership changes with the Society and its
possible consequences for the wider profession in its dealings with the
HPC. It was established that the decision making process within the SCP
was flawed and that had possible damaging effects for the organisation and
its members. In seeking clarification on the process we were able to
examine the methodology by which the Council reaches its decisions. This
highlighted a number of areas of concern, which, if not acted upon, would
weaken the democratic process considerably and undermine the relationship
between the organisation and its membership. At a time of considerable
change in healthcare delivery and regulation, this decline in trust could
prove fatal and such a result would prove disastrous, even for those
practitioners who cannot be counted as members. In that respect, holding
such a discussion within the public domain was both desirable and
essential; and yet for all that, its conclusion remains
unsatisfactory.

I would argue that there is little point in holding reasoned argument
unless some conclusion is reached. Invariably this means compromise and by
inference some conciliation will occur between the respective
propositions. If there is no conclusion there can be no conciliation and
this state invariably leads to resentment and suspicion. Not a good basis
for future debate. Having read most of the political and strategic debates
in these archives over the past summer, I was struck by how quickly the
argument deteriorated into defensive and presupposed logic. Once this
position was reached, often within a matter of days, the discussion
stopped. On many occasions this led to the resignation of individuals from
the forum and that, in itself, is surely a sign of failure. If we cannot
sustain criticism or deliver it in a manner that is not objective or
productive, this profession will never raise itself from the lowly status
it currently holds. In that respect I conclude that the only barrier to
progress is ourselves! We hold the key to advancement, not the HPC. And
the responsibility lies with the individual rather than the collective.
Debate must be open, honest and reasoned. These are the parameters that
must be adhered to.

To return to the debate on Society membership.

Ralph gave the impression that the decision was collective and
authoritative and that the basis for opening membership had validity. His
position was largely unsupported although I note one colleague on Council
confirmed his support on the SCP forum. As no other contributor to the
debate was present during the July meeting, Ralph’s position could remain
unchallenged although the process of engaging membership in consultation
certainly was not. Until Friday last, it appeared as if this would lead to
another inconclusive stalemate. Then I received an email from a colleague
who noted another Council member had decided to speak out on a matter of
conscience.

The points that she raised give rise to a number of concerns regarding
accountability and representation. I reproduce some of her comments with
the intent, not of causing embarrassment or approbation, but of opening a
further discussion on how best we, within the entire profession, can
structure future debate appropriately.

She writes:

“I am a Council Member and certainly did not vote for, or support this
proposal at the July Council meeting.

A letter from the Chairman of Council to Council Members dated the 24th
June 2004, referred in part to Council's "Corporate Governance"
conventions, which inhibited responses from members of Council, other than
those who are presumably delegated to speak publicly on this issue of
policy.

This may be why most Council members have been silent.

Advice has been sought and in general indicates such conventions are
voluntary and in circumstances where the "Articles" are in question
Council members should respond. Nor should Council members feel unable to
speak on an issue of conscience.”

She goes on,

“I did not agree with this decision and felt we should consult the
membership over such a momentous decision. I, personally feel any
chiropodist or podiatrist should take some form of examination to become a
full member of my Society.

Since 1954 (50years), we have had a three year full time training for
entry to our Society, and State Registration since the 1960s.Prior to that
entry to the Society was following a two year full time course and
examination. Since the early 80s we have had degree training, further
enhancing our skills and developing our profession.

After graduation, our members can now choose to become generalists or
after further study and training specialise in diabetic care, musculo-
skeletal problems, foot surgery, etc, entirely due to a sound basic
training. We have come a very long way since I qualified in 1969.

Throughout my professional career I could confidently say to my
patients, ‘always look for the letters S.R.Ch. when you look for a
chiropodist, because that means they have undertaken a three year training
recognised by the state’. I could refer a patient to a
chiropodist/podiatrist in another town knowing that they would have
completed a recognised training.

I cannot do that now, because the HPC is ‘grandfathering’ in all manner of
foot care "professionals". Furthermore, we will not have any control over
who the HPC chooses to recognise at any time in the future. They could
totally "dumb down" the requirements at any time.

However, a Professional Body, like the Society does have control over who
it admits to its membership. We are neither the HPC, nor the NHS. [But] we
can have standards of our own.

Until the 1st August 2004, I knew that although S.R.Ch had gone I could
still say "look for the letters M.Ch.S, or F.Ch.S.

Not anymore, due to Council acting beyond its powers by voting in July to
accept anyone registered by the HPC. According to our articles, no one can
be admitted as a member unless they satisfy one of the conditions of
Article 8.”

And finally…

“My personal view is that we need to have a proper consultative process
amongst ourselves, to discuss where we want our Profession to go, what we
want for ourselves, what is best for our patients, and what is best for
the whole of our profession not just the NHS.

We need to take some time to discuss the whole matter fully, openly and
honestly with the whole of the practising membership, as well as NHS
managers, Educationalists and Students.”

This letter raises a number of issues that must be addressed if future
debate is to be conducted for the benefit of the profession in the UK
First and foremost, I do not believe that any member of this profession
should feel inhibited from participation. Adhering to the ‘party-line’
rarely contributes to openness and democracy and on issues of such
magnitude; it simply engenders disaffection and apathy. Is that what we
really want?

I invited Ralph to make a statement yesterday regarding the Society’s
position but to little effect. Ralph, I would like to reinforce the
comments I made on the 4th September, at the outset of the debate. I do
believe you are the best placed to lead the profession through these
difficult times and I also believe that the Society is more than competent
in securing substantive professional goals. But I also believe that these
objectives will be more forthcoming if the wider profession was engaged in
a spirit of co-operation and trust.

Would you care to start the process off?

In all humility,

Yours sincerely

Mark Russell



“The meaning of things lies not in things themselves, but in our attitudes
to them.”

   Antione de Saint-Exupéry

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