Psycotherapy, 24th February 2010

Adjournment Debate – Dail Eireann – Regulation of psychotherapy and counselling in Ireland – 24th February 2010

Deputy Dan Neville

I welcome the opportunity to raise this issue, which I have raised previously over a number of years. I am prompted to do so having attended and addressed the European Association of Psychotherapy Conference in Vienna last week, which provided a great understanding of and much information in regard to what is happening in Europe.

I again express my concern that there are no statutory regulations in Ireland for the registration of psychotherapists and counsellors. There is no State control over who and what qualifications are held by those practising in these areas. It is dangerous for untrained, unskilled people to probe others’ unconsciousness. They are dealing with human vulnerability and serious damage can be done to such delicate people.

The Government introduced the Health and Social Care Professionals Act 2005 to provide for the registration of persons qualifying to use the title of a designated profession and for the determination of complaints relating to their fitness to practice. Some 12 professions are listed as designated professions under the Act. When I challenged the then Minister, former Deputy O’Malley, on this issue during the debate on that Bill in the Dáil, he stated that regulated professionals had become so regulated by a process of discussion and consensus. However, the psychotherapists and counsellors group failed at that time to agree an approach to the regulations. The Minister stated that statutory regulation in such circumstances would have serious legal implications. He accepted the principle that all psychotherapists and counsellors should be properly qualified and pointed out that in consultation with the professional groups involved he was unable to obtain agreement on the criteria. The Minister stated that he asked the groups to revert to him with agreed proposals and that he could, rather than return the matter to the Dáil, designate them under ministerial order.

In response to the Minister’s request, 22 organisations established a psychological therapies forum for counselling and psychotherapy. The forum accepted that it was imperative that the public is protected by the promotion of high standards of conduct, education, training and competence among the professionals of counselling and psychotherapy. It pointed out that all bodies involved with the forum provided a code of ethics by which their members must abide. It further stated that while this form of self-regulation provides protection to clients of these organisations, it falls short of optimal protection, as under our common law system it is possible for any person to take the title of counsellor or psychotherapist and practise accordingly without any training or competence. In other words, any person can put up a sign stating they are a counsellor or psychotherapist and charge €80 per hour for performing an act as a psychotherapist or counsellor, which is extremely dangerous to vulnerable people.

The current anomaly does not lend itself to good clinical governance and the maintenance of high standards of patient care. The Health and Social Care Professionals Act 2005 provides a mechanism to drive forward the clinical governance agenda. It creates a framework through which practitioners are accountable for continually improving the quality of their service and safeguarding high standards of care by creating an environment where excellence will flourish and optimal protection is afforded to the public who access counselling and psychotherapy.

The psychological therapists forum provided a proposal for statutory regulation of counsellors and psychotherapists. We have been informed that the 12 organisations already designated must have full recognition of designation before counsellors and psychotherapists are included in the Bill. This is critical to vulnerable people in crisis who will be damaged by counsellors and psychotherapists who are not properly trained or qualified, people who are mavericks involved in this area. We believe the issue of their designation should be given priority under the Bill.

Minister of State at the Department of Health and Children (Deputy Barry Andrews)

I am replying to this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank the Deputy for raising this issue and for giving me the opportunity to update the House on the ongoing regulatory programme undertaken by the Department of Health and Children, including the regulation of health and social care professionals.

The Health and Social Care Professionals Act was passed by the Oireachtas in 2005. The Act provides for the establishment of a system of statutory registration for 12 health and social care professions. The 12 professions to be regulated under the Act are clinical biochemists, dieticians, medical scientists, occupational therapists, orthoptists, physiotherapists, podiatrists, psychologists, radiographers, social care workers, social workers, and speech and language therapists. This new system of statutory registration will apply to the 12 professions regardless of whether they work in the public or private sector or are self-employed and it is the first time that fitness to practise procedures for those professions will be put in place on a statutory basis.

The structure of the system of statutory registration will comprise a registration board for each of the professions to be registered, a health and social care professionals council with overall responsibility for the regulatory system and a committee structure to deal with disciplinary matters. As a first step in the implementation of the system of statutory registration, the Minister for Health and Children launched the Health and Social Care Professionals Council in March 2007. The chief executive officer of the council was appointed in 2008 and additional senior administrative staff took up duty with the council in late 2009. The council must establish a registration board for each of the 12 professions currently covered by the Act. These appointments, and further progress in the establishment of a suitable organisational structure, will greatly assist the council in its ongoing work in preparing for the establishment of the individual registration boards, the first of which, the social work registration board, is to be established shortly.

The council is currently working to put in place the necessary structures for registration, education and fitness to practise for the 12 health and social care professions designated in the Act and it is hoped to bring additional registration boards on stream in late 2010. The council will enable health and social care professionals to practice in a regulated, controlled and safe environment and in a manner which will ensure the provision of high quality interventions, meeting the challenges of increasingly complex and evolving care for service users. Health and social care professionals will be facilitated in ensuring responsible and accountable practices while providing the highest level of patient care and service.

While the proposed system of statutory registration applies in the first instance to 12 health and social care professions mentioned, the legislation empowers the Minister for Health and Children to include, on the basis of specific criteria, additional health and social care professions in the regulatory system over time, as appropriate. The priority for the Health and Social Care Professionals Council is to establish in the first instance statutory registration for the 12 designated health and social care professions. The issue of inclusion of other grades, such as psychotherapists and counsellors, within the scope of statutory registration, will be considered after the initial designated 12 professional grades have been fully addressed.