REGULATION: THE PLOT THICKENS
In order to understand better recent developments in the field of regulation, the following outline of the principal groups of players may be helpful.
At the top are the regulatory bodies of the state, including the Health Professions Council (HPC), and the Department of Health (DoH), which is the branch of government that will promote regulation. Then come those bodies, some of which claim to be professional bodies but which are in fact principally, if not exclusively, concerned with voluntary regulation of practitioners but whose aim is ultimately compulsory regulation. This grouping of organisations is known as the Partnership Group, which currently comprises, amongst others, UKCP and BACP and includes the British Psychological Society (BPS). Finally comes a group of other bodies with an interest in regulation which are not necessarily regulatory bodies and some of which might more accurately be described as predominantly professional bodies. This is known as the Regulation Reference Group. This grouping of organisations arose out of the research and review of the nature of the professions of counselling and psychotherapy, known as the mapping process, carried out jointly by UKCP and BACP under the direction of DoH just over a year ago. The College is a member of this Regulation Reference Group.
The College has secured this position without giving up the right to seriously challenge and question the whole idea of regulation by the state.
The College has always argued the position that, if there is to be state-regulation of the profession, HPC, as it is currently constituted, would not be a suitable regulator. The reasons for this are set out in several documents published on this website. The College has also taken the position that, if regulation by the state does come about, this should be achieved by a body which is specifically oriented towards the psychological therapies, rather than HPC, which is oriented towards professions ancillary to medicine. It is now clear that UKCP and BACP have come to a similar conclusion.
In November 2005, representatives of The College attended the initial meeting of the then newly-formed Regulation Reference Group. The meeting was addressed by Rosalind Mead from DoH, advocating the way forward towards state-regulation and has been reported on in an earlier item in Latest News.
Following this, in December 2005, The College submitted a response to the call for ideas in connection with what has become known as the Foster Review, about regulation of the professions seen by the DoH as ancillary to medicine, including the professions concerned with the psychological therapies. This document is available via the DoH website.
Also in December 2005, The College wrote to the DoH identifying the precise location of The College on the professional scene and requesting an undertaking that we would be assured a place at future discussions concerning regulation. That assurance was forthcoming and access to the correspondence relating to this is also available from a link elsewhere in Latest News.
Consistent with this undertaking, The College, along with other organisations in the field, was notified in July by the DoH that a planning meeting of sector skills councils, qualifications authorities and others with expertise in competence development would be setting up a competence framework covering the practice of psychotherapists and counsellors and that the organisation Skills for Health, which is itself a part of The Sector Skills Council for Health, would coordinate the production of an initial framework to identify the scope of practice involved and that The College would be invited to participate.
The way forward via the determination and specification of competencies for our profession was regarded by many psychoanalytic practitioners, and possibly by most, as bad news for psychoanalysis. Again a critique setting out the arguments against this approach is on this website and is accessible from a link elsewhere in Latest News.
This month, The College has received a formal letter from Skills for Health, inviting The College to participate when the consultation process takes place between 1st December and the end of February 2007. UKCP in particular has already done a great deal of work in this area. Interestingly, however, Skills for Health went out of its way to give an assurance that the work and submissions of UKCP should not be taken as prejudging these issues and that the report already published by UKCP will constitute only one submission in the global consultation process.
Returning to the Foster Review, its findings were published in July 2006, almost simultaneously with the government's new proposals for regulation of the medical profession. As reported previously in Latest News, the two reports were presented very much as a joint bundle. The principal recommendation of the Foster Review was that there should be fewer regulators rather than a proliferation of specialised regulators and that the psychological therapies should be regulated via HPC, as if all practitioners were employed in the public services. It seems very clear from this that the government will not countenance a regulator oriented more specifically to the professions dealing with the psychological therapies. Nevertheless, DoH who published the Foster Review, called for submissions from all interested parties in a consultation process that would end on 10th November.
In order to contextualise the next development, it is helpful to note that, some time ago, BPS completed their own discussions with HPC, designed to lead to state-regulation by HPC of applied psychologists. The conclusion reached by BPS at the end of those discussions was that regulation by HPC would not be appropriate because, according to them, such regulation would not be sufficiently rigorous. Those who want to know more about this will find ample documentation and details on the BPS website.
Under existing legislation, the Secretary of State has to hold a public consultation of proposals for regulation by HPC and, until now, it has not been the practice of HPC to regulate professions that are opposed to regulation. Apparently that could be about to change in legislation currently before Parliament, enabling the government to regulate professions against their will. Furthermore, the government appears to have made it clear that, following these changes, it will regulate, via HPC, not only applied psychologists but also, probably, academic psychologists, who were never intended for regulation under the original discussions BPS had with HPC. It seems that there is an increasing determination by the government to regulate, almost immediately via HPC, psychologists of all descriptions and, ultimately within a few years, all practitioners of the psychological therapies, also via HPC.
At relatively short notice, a meeting of the Regulation Reference Group was convened on 10th October, which was attended by a representative of The College. What emerged was a joint presentation by UKCP, BACP and BPS, calling for the Regulation Reference Group to agree to make, by 10th November, a joint submission with the Partnership Group in the consultation process arising out of the Foster Review. The principal component of this submission comprised a fairly detailed outline for a new Psychological Professions Council (PPC) to regulate those professions allied to psychology, alongside those professions concerned with the psychological therapies. Although a version of this document was published on the BPS website, it subsequently emerged that the document is the result of a collaboration between BPS, UKCP and BACP. It was difficult at this meeting not to feel somewhat steam-rollered by these proposals, arising out of the immediate threat to psychologists at a time when no similar threat to practitioners of counselling and psychotherapy arises in the immediate future.
The College made every attempt to play a constructive role in these discussions and indicated that it might be possible to agree to a joint statement that was sufficiently widely worded and in a manner that would entail no definite commitment of any kind on the part of The College. In the end, the draft statement submitted by the Partnership Group for agreement by the Regulation Reference Group was too specific and insufficiently widely expressed to enable The College to agree to subscribe to it. As there was almost no time for further discussion, The College declined to subscribe but expressed its willingness to continue in constructive discussion about these issues.
In the end, The College made its own submission, under the consultation process arising from the Foster Review. A copy of that submission can be accessed by clicking this link.
The College was not the only body in the Regulation Reference Group to express reservations about these proposals. The AP-PP Section of UKCP in particular, also a membr of the Reference Group, had similar reservations. Furthermore, it is understood that BPC, also a member of the Reference Group (but not the Partnership Group) was not prepared to move away from the principle of regulation by HPC in favour of a body such as the proposed PPC.
Had The College been prepared to go along with what was being proposed by the Partnership Group, it would have been only on the basis of exploring the possibility of setting up a body such as the PPC but certainly not on the terms drafted by the Partnership Group. All aspects of the proposals must remain up for discussion, including the name itself of the proposed PPC.
Discussions within the Regulation Reference Group will continue and it is possible that this body will play an increasingly important role within the discussions for regulation of the psychological therapies by the state. The Partnership Group can now be in no doubt that there is, from some quarters, a degree of opposition to the principle of PPC, as well as wider opposition to the details of some of their proposals in the draft PPC document so far produced.