It is a great pleasure, Mr Hood, to serve under your chairmanship. I am raising this debate as part of an ongoing discussion on gay-to-straight conversion therapy, and I refer to my early-day motion, which attracted 52 signatures; the petition presented to the House by my hon. Friend Diana Johnson; and the private Member’s Bill, the Counsellors and Psychotherapists (Regulation) Bill, which was introduced by my hon. Friend Geraint Davies.
I congratulate my hon. Friend on securing this debate. I want to put on record the enormously helpful work of Tom Stevens and Colin Levitt, who live in Hull and were behind the petition that was presented to Parliament because they felt strongly about the matter and decided something had to be done.
I, too, have reason to be grateful to those people.
I want to place on the record the fact several hon. Members indicated that they wanted to attend this debate but had other commitments.
As my hon. Friend was so kind as to mention my Bill, does she agree that our joint ambition to get rid of gay-to-straight conversion therapy needs to be embraced in a regulatory context so that all psychotherapists are regulated, which they are not at present?
I agree, and I will go into that further. Conversion or reparative therapy is the attempt by individuals, often posing as professionals, to try to alter the sexuality of lesbian, gay or bisexual patients. Virtually every major national and international professional organisation has condemned the practice as ineffective and potentially extremely harmful to patients.
I thank the hon. Gentleman for his intervention.
The prevalence of conversion therapy in Britain has been the subject of recent interest in Parliament. Hon. Members will have received a recent communiqué from the pro-conversion group, Core Issues, calling on us not to support the private Member’s Bill introduced by my hon. Friend the Member for Swansea West on the regulation of counsellors and psychotherapists. The people in Core Issues are the very same who tried and, fortunately, failed to put up posters on London buses advertising conversion therapy. On
Does the hon. Lady agree that such courses are particularly dangerous for young people who are struggling with their sexuality? When I was a teenager, I had great difficulty reconciling who I was. The variability of those courses places an enormous burden on young people who are already frightened about the consequences of being open about who they are.
Thank you, Mr Hood.
I want to focus on the main aspects of the problem of conversion therapy, and to debunk three common myths: first, that conversion therapy is something that happens only in America; secondly, that conversion therapy is carried out only by religious fundamentalists operating outside professional channels; thirdly, that the debate about conversion therapy is a simplistic one between allowing people freely to choose conversion therapy and infringing people’s personal choices. On the contrary, I hope to show that conversion therapy is a real and present danger in Britain, and that instead of being a problem just among religious fundamentalists, it is an issue for the national health service and the professional sector. This is not a simplistic debate about freedom to choose. If lesbian, gay, bisexual and transgender community patients are coaxed into undertaking therapy by peer pressure or referred to conversion therapists after approaching professionals, that is hardly free choice.
Does the hon. Lady agree that until now the Department of Health has been weak on the matter. Instead of condoning it, it should ban the voodoo medicine and conversion therapy?
I agree with the hon. Gentleman and I hope to get some answers from the Minister.
Conversion therapy used to be a much greater and more systemic problem in Britain than it is today. In the 1950s and ’60s, LGBT patients were routinely forwarded by teachers, GPs and, as in the case of Alan Turing, criminal courts to NHS so-called specialists in sexual orientation treatment. During that period, all branches of psychology from the cognitive to the behavioural and the psychodynamic had their own cruel and unpalatable methods of dealing with same-sex attraction.
The watershed moment came when homosexuality was removed from the American “Diagnostic and Statistical Manual of Mental Disorders” in 1973. However, simply changing the rules does not change an entire system overnight. Conversion therapy persisted and psychotherapy remains an unregulated profession in Britain. Anyone in the country can set up as a psychotherapist without being part of a professional body, and there are professionals practising in the NHS and therapy sectors who received their training well before homosexuality ceased to be classed a mental illness. Even the new intake of therapists is a cause for concern.
In 2008, a survey of 226 British psychology undergraduates was published in the Journal of Homosexuality and found that only 66% agreed with an equal age of consent. That is the context in which we should view the extent of conversion therapy in Britain. In a 2009 survey of more than 1,300 accredited mental health professionals, nearly 300 willingly admitted to having attempted to change at least one patient’s sexuality. Even more shocking, the therapists admitted that some 35% of the patients they treated were referred to them for treatment by GPs, and 40% were treated inside an NHS practice.
Does my hon. Friend agree that it is very serious that the issue is so widespread among GPs and other professionals, and that we must tackle that when regulating psychotherapy and the health professionals who refer people?
The issue is serious and it is not recognised to the extent it should be, which is one reason why I am so pleased that we are having this debate.
In 2010, Patrick Strudwick of The Independent carried out an undercover investigation. One psychotherapist who attempted to “cure” him, Lesley Pilkington, readily admitted that most of her clients were referred to her from her local GP’s surgery. Many professionals receive little training in what to do when a gay person approaches them expressing uneasiness about their sexuality. There is legitimate concern that some professionals in the NHS and elsewhere are referring LGBT patients to conversion therapists.
Addressing the problem of conversion therapy in Britain requires a range of measures. In the therapeutic profession, affirmative therapy, which begins from the premise that no efforts should be made to change sexuality and that homosexuality is perfectly normal, should be promoted as the appropriate, healthy way of assisting LGBT patients who feel uneasy about their sexuality. To promote this therapy, we must ensure that therapists and students are properly trained in LGBT-friendly mental health provision.
The public sector equality duty mandates the public sector to address inequality and is vital to drive forward reform. That is why recent Government calls to review the duty are particularly concerning. It is important to consider the role that the public sector equality duty can play in improving the quality of care for LGBT patients. What initiatives has the Department of Health supported from the Equality and Human Rights Commission, for example, and from non-governmental organisations such as Stonewall, to identify and promote good practice in relation to the public sector equality duty and LGBT patients? We know that when public bodies are proactive, it can make a real difference.
We need to explore the regulation of psychotherapy. At the very least, it has to become a protected profession in which nobody can legally call themselves a psychotherapist without being accredited by a professional body. We also need to ensure that professional bodies have an appropriate complaints procedure, so that LGBT patients who undergo conversion therapy can achieve justice. Patrick Strudwick, to whom I referred, has raised concerns about the complex bureaucratic process that he had to go through to ensure that the conversion therapist who treated him was struck off her professional body.
We need to ensure that psychotherapists who are not members of those professional bodies that explicitly have a position against conversion therapy are not commissioned by the NHS. Will the Minister tell us whether groups without professional affiliations are commissioned by the NHS for services? What about the advertising to which I referred earlier? A New York Times advert in the ’90s for conversion therapy is credited with causing a revival in the practice. That is why restricting advertisements for conversion therapies is vital and should be explored. What is the Minister’s view on that?
At the very least, the Government must force practitioner full disclosure, which was advocated as the desired alternative to the model of Health Professions Council regulation in the Maresfield report of 2009, and involves
“the establishment of an independent body to administer a register of therapists, with the statutory requirement that anyone practising a therapy supply full details of training and professional history.”
The Government’s regulatory model for psychotherapy falls far short of PFD. Why?
Finally, I want to raise the question of the role of the law in tackling the practice of conversion therapy. The Government could opt to ban conversion therapy for all under-18s and go further with an all-out ban for all age groups, as happens in other countries.
I congratulate the hon. Lady on the measures that she has outlined and support her fully. Is it not the case that in 21st-century Britain, no lesbian, gay, bisexual or transsexual individual should be accessing this kind of voodoo psychology? Instead, we should provide services that help to give confidence and which support them in discovering their sexuality and about themselves, rather than making them feel more ashamed about it.
I totally agree, and thank the hon. Gentleman for his contribution. In addition to a ban, we must go further in the training of professionals who are dealing with LGBT patients and provide friendly public service provision.
Other than a solitary remark from the Government that they do “not condone” conversion therapy, made in response to a written question tabled by my hon. Friend the Member for Kingston upon Hull North, the Government have said nothing about their views on conversion therapy. I look forward to the contribution of other Members and, in particular, to the Minister’s reply on the issues that I have raised.
I have received a letter from Mrs Hodgson requesting permission to speak in the debate. She assures me that she has had the agreement of Sandra Osborne, and the Minister has told me that he agrees. To be fair to the Minister, he has to have the same time as the hon. Member for Ayr, Carrick and Cumnock had in opening the debate, so I ask the hon. Member for Washington and Sunderland West to take only a few minutes, which will hopefully leave time for the Minister.
I congratulate my hon. Friend Sandra Osborne on securing the debate, and on her powerful speech setting out the problem that we are hoping the Government can solve. I thank her, the Chair and the Minister for allowing me and other hon. Members to make small contributions to the debate.
I should also pay tribute to the many Members on both sides who have campaigned on the issue, particularly my hon. Friend Geraint Davies for his excellent private Member’s Bill, and my hon. Friend Diana Johnson, who did a national petition on the matter.
This debate comes during an important week for the LGBT community. On Monday, we celebrated the 10th anniversary of the abolition of the wretched section 28, and today is the annual transgender day of remembrance, when we remember the thousands of transgender people across the world who have paid the ultimate price, simply for seeking to be themselves. Those men and women have lost their lives at the hands of hate-filled zealots, because they had the courage to be who they wanted to be.
Pushing conversion therapy on people who are homosexual might not be on the same level as physical attacks on a member of the LGBT community, but it is certainly part of the wider problem of discrimination against them. That said, the psychological harm that medical professionals have recognised as a side effect of such attempts to change or tone down sexuality could well lead to the same end result.
Let us be absolutely clear: allowing the continuation of so-called therapists offering gay cures is, first, saying that being gay is problem that needs to be cured, and secondly, that it can be cured. Being gay is not an affliction. The only higher power that I defer to on the matter is the World Health Organisation, which has categorically confirmed that fact. Being gay cannot be cured any more than any other aspect of someone’s personality can be changed without doing that person serious damage.
What we want from the Government is similarly clear. The action taken last year by the British Association for Counselling and Psychotherapy, and in 2010 by the UK Council for Psychotherapy, is welcome. However, they cannot solve the problems themselves if the people they strike off their registers can still legally continue to call themselves therapists.
We need a system to ensure that counsellors and therapists are properly accountable. A statutory register has been put forward in the past as a solution to the problem, and in the absence of any better ideas, I still think that that is the way to go. However, I would be grateful for any other solution that the Minister can put forward that would have the same effect.
While such a system is set up, no doctor practising in this country—and certainly no doctor paid by our NHS—should be sending any of their patients to conversion therapy. Even if that patient begs to be referred, doctors swear an oath to do no harm, not to do whatever their patient asks them to do. We know that conversion therapy is harmful and doctors should know that too.
We also know that the majority of people who request conversion therapy do so because of pressure or abuse from family or peers—
Thank you, Mr Hood. I congratulate Sandra Osborne on securing the debate and thank Mrs Hodgson for her contribution, which I was pleased to hear as well. I found myself agreeing with the vast bulk of what has been said and with the interventions that have been made—in fact, I agreed with everything that has been said.
Personally, I find the practice utterly abhorrent and it has no place in a modern society. That is my personal view, and many of the questions that have been asked are questions that I have asked officials about the powers that might be available. If hon. Members would welcome it, I would be very happy to meet with all of them or a group of them to discuss the matter further. That is an open offer, which I make genuinely.
The Government have a proud record of supporting the rights of lesbian, gay and bisexual people. Most recently, we witnessed and welcomed the enactment of the Marriage (Same Sex Couples) Act 2013. Our support for the legislation demonstrates absolutely our belief that extending the right to marry to lesbians and gay men is part of recognising that loving and committed relationships and families in modern Britain come in all shapes and sizes and should be celebrated.
I thank the hon. Lady for that intervention, and I note her point. Being lesbian, gay or bisexual is not an illness—it is sad that we need to state that, but it needs to be stated. It is not an illness to be treated or cured. Way back in 1973, the American Psychiatric Association removed homosexuality from its diagnostic glossary of mental disorders. Thankfully, the international classification of diseases produced by the World Health Organisation eventually followed suit in 1992; there was quite a long delay before that happened. Therefore, we are concerned about the issue of so-called gay-to-straight conversion therapy.
The Department of Health has received 15 or so letters in the past few months about the issue. All but one of those letters have been supportive of gay people and against the notion of gay-to-straight conversion therapy. That surely reflects the fact that most people in society today are far more relaxed and understanding about people’s sexuality than they ever were in the past.
We are not aware that the NHS commissions this type of therapy. It is completely inappropriate for any GP to be referring a patient for such a thing. It is unacceptable that that should happen through someone working in our national health service.
Is the Minister aware that the number of people who go to psychotherapists has tripled under this Government to 1 million? Given that number and given that we have heard evidence about people being referred by GPs, is it not now high time for regulation to stop abuse and potential abuse?
I will come to that. I do not think that the fact that numbers have increased can be blamed on this Government.
We are not aware that the NHS commissions this type of therapy. In my replies to correspondence, I have confirmed that the Department of Health does not recommend the use of conversion therapy—I have made clear today my personal view on that—and it is not a National Institute for Health and Care Excellence-recommended treatment. That is self-evident. Furthermore, the main national professional associations for psycho- therapy have declared that they regard conversion therapy as wrong.
In February 2010, the UK Council for Psychotherapy said:
“UKCP does not consider homosexuality or bisexuality, or transsexual and transgendered states, to be pathologies, mental disorders or indicative of developmental arrest. These are not symptoms to be treated by psychotherapists, in the sense of attempting to change or remove them.
It follows”— this is very important—
“that no responsible psychotherapist will attempt to ‘convert’ a client from homosexuality to heterosexuality”.
Similarly, in September 2012, the British Association for Counselling and Psychotherapy set out the following:
“The…Association…is dedicated to social diversity, equality and inclusivity of treatment without discrimination of any kind. BACP opposes any psychological treatment such as ‘reparative’ or ‘conversion’ therapy which is based upon the assumption that homosexuality is a mental disorder, or based on the premise that the client/patient should change his/her sexuality.”
In January 2013, the British Psychological Society published a position statement that opposed any psychological, psychotherapeutic or counselling treatments or interventions that view same-sex sexual orientations as diagnosable illnesses. It declared:
“This includes freedom from harassment or discrimination in any sphere, and a right to protection from therapies that are potentially damaging”— that point was made by hon. Members—
“particularly those that purport to change or ‘convert’ sexual orientation.”
This issue is clearly causing a great deal of concern in the House, and rightly so. The hon. Member for Ayr, Carrick and Cumnock, as well as sponsoring this important debate, tabled an early-day motion in June. It called on the Government to take steps to ban gay conversion therapy and to investigate NHS links to conversion therapists. Several hon. Members present have referred to that motion and put their names to it.
Geraint Daviestabled a second early-day motion, calling on the Government to regulate counsellors and psychotherapists. There have also been a number of parliamentary questions on the issue. As hon. Members will know, the hon. Member for Swansea West has also introduced a private Member’s Bill seeking regulation of therapists. That is scheduled for Second Reading this Friday.
The Government have already said that there are no plans at this stage to introduce statutory regulation of psychotherapists. We do not believe that regulation would necessarily prevent this type of counselling in any case, as it would not depend on the type of therapy offered.
The Command Paper entitled “Enabling Excellence: Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers”, which we published in February 2011, sets out the Government’s vision for the future of work force regulation. That paper makes clear our continuing view that, although statutory regulation is sometimes necessary, it is not always the most proportionate or effective means of assuring the safe and effective care of patients or social care service users. That is why we provided powers to the Professional Standards Authority for Health and Social Care in the Health and Social Care Act 2012.
The Professional Standards Authority oversees the work of the health care profession regulators, including the Health and Care Professions Council. Those powers facilitated the establishment of voluntary registers for unregulated health care professionals and health care workers in the UK, social care workers in England and certain students.
The accredited voluntary registration scheme to which I am referring is not a form of regulation, nor is the PSA a regulator. To be accredited, organisations must provide evidence to the PSA that they are well run and they require registrants to meet high standards of personal behaviour, technical competence and, where relevant, business practice, but the scheme does not endorse any particular therapy as effective and it makes it clear that accreditation does not imply that it has done so. However, organisations seeking to be accredited can set their own rules about what therapies their members can or cannot offer.
As accredited voluntary registration appears to be gaining momentum and is proportionate to the risk, we believe that statutory regulation would not be appropriate and the costs to registrants or the taxpayer could not be justified. This is not to say that we are ruling out statutory regulation for this group for ever. We will continue to assess the need for it. I give an absolute assurance about that.
This is not to say that lesbians, gay men and bisexual people cannot seek counselling or therapy because they are distressed about a particular aspect of their sexuality—that is very important—or that a therapist should not try to help their patient with whatever is causing them distress, which may involve helping them to come to terms with their sexuality, family arguments over their sexuality, or hostility from other people. Supporting people through aspects of their lives that are difficult or challenging is a large part of what therapists do. I think that my hon. Friend Stephen Gilbert made that point in his intervention.
We want to minimise the risk that lesbians, gay men and bisexual people who seek counselling about their sexuality will face therapists attempting to change their sexual orientation because the therapist considers that being gay is wrong. That, of course, is completely unacceptable. That is why Department of Health officials last week met representatives from the UK Council for
Psychotherapy to discuss a way forward on this important and sensitive issue. Officials will work in partnership with the council in the following ways.
First, the UK Council for Psychotherapy has agreed to draft, in consultation with the other relevant professional bodies, a public statement on conversion therapy that provides information and outlines the views held by those organisations. That is incredibly important. Once produced, that statement will be widely publicised and placed on relevant websites to ensure that individuals seeking a counsellor or therapist will be aware of those bodies’ views on gay conversion therapy.
Secondly, the Department of Health will host a round-table event in the spring to which it will invite relevant individuals and organisations in order to discuss ways to achieve greater quality and consistency across the profession in general, as well as on this specific issue. Thirdly, and subject to the progress of the private Member’s Bill, the Department will consider writing to statutory regulators, setting out key principles, to be agreed with the professional bodies.
In addition, although we are not aware of such therapies being commissioned by the NHS, my officials will explore with NHS England what actions it can take to ensure that clinical commissioning groups are not commissioning them locally. That is one of the issues that I am happy to discuss with hon. Members. I totally agree that it is not something that public money should have anything to do with.
I hope that I have assured those who have spoken passionately and persuasively in today’s debate that the Government are listening and taking action. I repeat my offer to meet hon. Members. We have a lot to be proud of. The UK is once again recognised as No. 1 in Europe on lesbian, gay, bisexual and transgender equality by the International Lesbian and Gay Association, and we continue to make great strides forward on equality. I hope that that reassures hon. Members both that this Government are strongly committed to advancing lesbian, gay and bisexual equality and that we are taking the issue of gay conversion therapy extremely seriously.