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

My Lords, I declare an interest in the parliamentary sense as a consultant psychiatrist in psychotherapy, and I run the Centre for Psychotherapy in Belfast, which is a National Health Service facility. I am grateful to the Minister for introducing the order. As the noble Earl, Lord Howe, said, she helpfully outlined some of the issues that come to the fore. There are a number of elements of the order to which I wish to draw attention. Like the noble Earl, I entirely welcome the emergency provisions and the safeguarding of vulnerable groups provisions that are put in place. Like him, I find these uncontentious. I understand that, with regard to the professional bodies, no particular objections have been lodged—for example, by the General Dental Council—to the changes that are proposed in the order, effectively to remove the possibility of professionals electing from among their own professional colleagues a number who would exert professional oversight. I am less sanguine about this development than many of those involved. The appointment of all members would mean that there is no real independent professional voice, for all effectively will be government appointees. The Government are an interested party in this matter, since in many of these professions they are an almost monopoly employer through the NHS. In the case of dentists, one of the problems is that a degree of disenchantment has meant that a very large number have left the NHS. I would have thought that that in itself was an interesting marker to which the Government and the General Dental Council might have paid attention. However, I do not wish to major on this, because it seems that the professionals in those areas are content to go with it. On the subject of regulatory peculiarities, I am used to inconsistencies between different orders. For example, as the noble Earl pointed out, I proposed about 10 years ago the establishment of a council for psychotherapy, and I shall return to that later. The Government insisted that they would not support such a proposal, because they were absolutely not going to have any further separate professional bodies; everything would be subsumed within the Health Professions Council. Then they promptly decided to create the General Pharmaceutical Council, referring to a much smaller number of professionals than would have been the case in psychotherapy, never mind within psychological therapies as a whole. So I am familiar with this kind of inconsistency between orders. However, here we have inconsistency within the order. There is now going to be a UK-wide application of a psychologist’s registration to all four parts of the United Kingdom, but Northern Ireland will be specifically excluded from statutory registration of pharmacy technicians. The order brings Scotland into line, but not Northern Ireland. I know that Northern Ireland is not easy to bring into line on a number of issues, but it seems to me particularly strange in this regard, for while there will be relatively few pharmacy technicians in Northern Ireland in numerical terms, and almost all of them will simply work within Northern Ireland, there are already a number of psychologists who operate across the border between Northern Ireland and the Republic of Ireland. It seems to me that there is something particularly strange here. I rather suspect—in fact, I am rather sure—that the Minister and her colleagues have been in consultation with the Northern Ireland Executive. I do not for a minute wish to hold her accountable for the decisions of the Northern Ireland Executive, if that were even possible. However, I would be interested to know whether any justification was requested on the differing decisions to have psychology as a UK-wide registration but to have Northern Ireland specifically excluded in respect of pharmacy technicians. The main issue is the new statutory registration of practitioner psychologists and the potential implications for psychotherapists and counsellors. The House will be aware that the subject of statutory registration for psychologists, psychotherapists and counsellors is one that I have pursued through two Private Members’ Bills, a number of Parliamentary Questions, debates and other modalities. I make it very clear that I am supportive of statutory regulation and registration. Indeed, if Her Majesty’s Government had accepted some of my proposals in this place 10 years ago, they would have been operative for some time. One argument at the time against my Bill was that it would take too long and that to pursue things through Section 60 of the then Health Bill would be much quicker and easier. At that time, I was conducting a number of discussions, which involved the BPS, UKCP, BCP, BACP, the Royal College of Psychiatrists, the Association of Child Psychotherapists and a number of other bodies. The department successfully wooed away the British Psychological Society with the promise that things would move much more quickly. The BPS had been pursuing the possibility of a Private Member’s Bill in another place bringing in registration. The department promised that things could move much more quickly if only the BPS would separate itself off from these difficult and contentious people in psychotherapy and counselling. Almost 10 years later, we find ourselves with an order for psychologists and with still nothing really in sight for psychotherapists and counsellors. I think that the concerns of the noble Baroness about the difficulties that there might be ahead are well informed. The HPC is being used but, in a letter dated 26 September 2006, the president of the BPS said that the BPS opposed having the HPC as a regulator because it was, ""not fit for that purpose"." That is why the BPS had engaged with other professional bodies and brought forward the proposal of a psychological professions council, which would, among other things, have brought all psychological therapies and professionals together. The Minister said that psychiatrists were the only ones that were currently regulated. This is almost the case, because it is also the case that arts psychotherapists are regulated through the Health Professions Council, so there is a little bit of experience there. A psychological professions council would bring all of them together, with a different understanding of things from that belonging to those working in the physical therapies and physical scientific approaches that are largely the base for the Health Professions Council. It is also the case, as has been mentioned, that the order has effectively split the profession of psychology. Those psychologists who are working specifically in healthcare and in a number of other areas will be separated off from those who are—if one might say so—the pure science, research academic psychologists, who will not be required to register; in some ways, it would not be appropriate for them to do so, because they are not health professionals. Effectively, this divorces them, which is a problem that would not have arisen if a psychological professions council had been the modality that was taken forward. I am puzzled as to why the Government have not proceeded with the psychological professions council. It is only a few minutes since the noble Lord, Lord Hunt of Kings Heath, was on the Front Bench making kind remarks about me. He was the Minister responsible in 2000 and 2001, when he indicated that there was a case for a separate council. In private, he endearingly called it a "talking heads council", but perhaps the term "psychological professions council" would be more congenial. I think that he did not entirely let go of his belief, even some time later. I would like the Minister to put on record why it has not been possible to create the new council. It cannot be a financial or an organisational question, because a much smaller number of practitioners is involved than with the General Pharmaceutical Council, yet it has been possible to establish that. Indeed—here I cast a sidelong glance at the noble Earl—it may not be long before a new Government are in place; they certainly will be before there are proposals for the regulation of psychotherapists and counsellors. I wonder whether that might be the time—for tonight does not appear to be the time—when we might rectify this misguided approach and establish a psychological professions council that would be the suitable home for psychologists, psychotherapists, counsellors, arts therapists and others, as such a council would understand more fully the complexities of the work and the difference between that work and what is appropriate for the Health Professions Council to regulate.