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Health Care and Associated Professions (Miscellaneous Amendments and Practitioner Psychologists) Order 2009

My Lords, the reforms set out in this draft order aim to enhance public confidence in the ability of the healthcare regulatory bodies to protect the public and deal with poor professional standards. The order continues the process of implementing the Government’s programme to improve patient safety through the reform and modernisation of the regulation of the healthcare professions, as set out in the White Paper, Trust, Assurance and Safety. I am aware that there has been a lot of interest in the build-up to this debate both in support of and against the provisions. There appears to be a good deal of confusion about the content of the order, what it provides for and what it does not. I should therefore like to spend a little time going through the provisions of the order and dealing with some of the issues that have been raised. This order introduces statutory regulation of practitioner psychologists across the UK. It is in this area that I think most of the confusion has arisen, so let me make clear now that the order makes no provision at all for the regulation of psychotherapists or counsellors. Psychologists, psychotherapists and counsellors are part of a number of professional groups offering talking therapies. At the moment, the only regulated group is psychiatrists, who are regulated as doctors by the GMC. As doctors they can also prescribe drugs to patients. The next highest qualified providers of talking therapies are practitioner psychologists, who are now being regulated for the first time. They must all have postgraduate qualifications. Consideration is also being given to the regulation of psychotherapists and counsellors who have descending levels of professional qualification. The Health Professions Council has been working with bodies representing these groups to develop proposals but we are not there yet. Those discussions are continuing but no formal decisions have been made although we understand that the working group is hoping to report to the council of the HPC later this year. Any proposals to regulate psychotherapists and counsellors will be subject to further consultation before legislation is brought before the House. Given the weight of interventions on this matter by psychotherapists, we anticipate robust discussion and consultation. Statutory regulation exists to protect the public from poorly performing practitioners. It does this essentially in three ways: first, by setting standards of practice, training and conduct; secondly, by registering those who have trained as competent and fit to practise; and thirdly, by operating a system to investigate and impose sanctions on registrants who are found unfit to practise. However, we do not wish to regulate for the sake of regulation. As regards practitioner psychologists, after much discussion and consultation we have identified seven areas of practice within the overarching discipline of psychology where the majority of those practising work with individuals or groups on interventions to improve their health or well-being, and as such carry the greatest potential for causing harm to their patients. These groups are clinical psychologists, health psychologists, counselling psychologists, forensic psychologists, educational psychologists, occupational psychologists and sport and exercise psychologists. We do not want to regulate all psychologists as this would capture significant numbers of psychologists who do not work with clients or patients and who form no risk to the health and well-being of individuals; for example, those psychologists working in the area of pure academic research, teachers and other psychology graduates who we do not wish statutorily to regulate. Nor do we want to protect the title "psychologist" for the exclusive use of those we are regulating as that would prevent these other groups who we do not wish to regulate but who have a legitimate claim to that title, from using it. I am aware that there are a number of chartered psychologists with practising certificates who the British Psychological Society consider should have their names automatically transferred to the new HPC register, along with those who are members of the seven divisions of the BPC, whose members will transfer automatically. However, it is not clear whether these chartered psychologists are entitled to membership of those seven divisions. If they are not, they are not at present allowed by the BPS to use the titles associated with membership of those divisions—for example, clinical psychologist—and as the BPS has not granted them the right to use those titles we are not prepared to provide for their automatic transfer to the new register, which would give them that right. However, we are asking the BPS to work with us to resolve these situations. I should emphasise that a cornerstone of statutory regulation is restricting the use of titles associated with a profession to those who should properly be entitled to use them. This means that the public can be reassured that a person who calls himself, for example, a clinical psychologist, is fully qualified and able to treat them as such. As a consequence of all this those BPS members with practising certificates who are not allowed by the BPS to use the basic protected titles will need, if they wish to use any of those protected titles, to apply to the HPC for registration once the statutory register opens. The HPC has indicated that it will recognise all existing qualifications that would have led to chartered psychologist status. If a BPS member holds one of these qualifications, they will be able to apply for registration in the same way as newly qualified psychologists. Any current practitioners who do not have recognised qualifications will be able to go through a process known as "grandparenting"—an assessment process under which each application is assessed individually before the applicant can be admitted to the statutory register. Under this process some applicants may be required to take a test of competence before registration is granted. The remainder of the order makes various amendments to the framework legislation for the regulation of dentists, dental care professionals, pharmacists, pharmacy technicians and those professions regulated by the Health Professions Council. It also extends the statutory regulation of pharmacy technicians to Scotland. Some Members present may recall the interesting debates last year on similar orders and the Health and Social Care Act. Changes to the governance arrangements of the General Dental Council and the Health Professions Council include moving each of these bodies from a partially elected to a fully and independently appointed council to ensure that professional interests should not unduly influence council deliberations. In the past year five other health professions regulators have already made this move: the General Medical Council; the General Chiropractic Council; the General Osteopathic Council; the General Optical Council and the Nursing and Midwifery Council. Other miscellaneous amendments include: the standardisation of the statutory duties to ensure that regulators consider the interests of stakeholders in their deliberations; new arrangements for accountability to Parliament, including a new requirement for each regulator to report on its arrangements for ensuring that it adheres to good practice in relation to equality and diversity; a new requirement for the GDC and HPC to publish a strategic plan; and new arrangements for the constitutions of statutory committees of the GDC and HPC. Amendments are made to the Safeguarding Vulnerable Groups Act 2006 and the Protection of Vulnerable Groups (Scotland) Act 2007 and to a range of fitness to practise rules for each of the regulatory bodies. These amendments will make it easier for regulators to strike off registrants who are barred from working with children or vulnerable adults when the new Independent Safeguarding Authority is established. Provisions in relation to emergencies such as pandemic flu will allow the registrar of the RPSGB to register anyone he considers suitably experienced as a pharmacist, such as recently retired pharmacists, during a public health emergency and to give enhanced prescribing rights to more of its registrants. I should perhaps also point out that in the debates elsewhere on this order, in both the House of Commons and the Scottish Parliament, the regulation of clinical physiologists and other scientist groups has been raised. Noble Lords may be aware that the role of clinical physiologists is being considered as part of the modernising scientific careers programme, about which the Department of Health recently consulted. Officials are considering the responses to that consultation before developing proposals for regulation. All the measures are supported by each of the regulatory bodies covered by this order. I commend it to the House.