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I Can See That from where Jonathan Pedder stands (interview in Free Associations 37) the concerns that have been expressed about NHS recruitment for posts in psychotherapy at consultant and senior registrar level might look like ‘nonsense’. But many experienced and senior NHS psychotherapists (medical and non-medical) have collectively expressed such concerns, for instance in the open letter published in Free Associations 6. 1, pp. 14-27, 1996. The concern extends beyond the signatories to the letter. The recent NHS Executive report ‘NHS Psychotherapy Services in England: Review of Strategic Policy’ (NHS Executive, 1996) noted that ‘in some parts of the country, notably London and the South East, the NHS is dependent on private institutions for specialist [psychotherapy] training of medical and other staff’ (s. 3.4.2).
The questions for discussion seem to be these:
Is it right that advancement in this NHS sub-discipline should very largely depend (at least in London and the South East) upon possession of a qualification from the private (and expensive) training offered at the Institute of Psycho-Analysis, a programme that is totally independent of public scrutiny and not subject to public accountability? The state of affairs in which nearly all consultant psychotherapists in London are members of the British Psycho-Analytical Society (the Institute's professional body) means that the pool from which recruitment can effectively be made is artificially reduced. I have heard a number of consultant and senior registrar psychotherapists in the regions express disappointment that they cannot even think about applying for jobs in London with a reasonable chance of success.
Is the selection process satisfactory? Although representatives of a number of outside bodies do attend, it can be shown that it is often the case that one or more of these is a psychoanalyst. This is in addition to the leading representatives of the local department also being psychoanalysts. No one is