Proposed regulation of Counsellors and Psychotherapists under the Health and Social Care Professionals Act 2005
Public Consultation – Submissions invited
The Minister for Health, Mr Simon Harris TD, in accordance with section 4(2)(b) of the Health and Social Care Professionals Act 2005, wishes to give interested persons, organisations and other bodies an opportunity to make representations to him concerning the proposed designation under the Act of the professions of counsellor and psychotherapist.
The issues which the Minister would like addressed by the submissions are listed in Appendix 1 below.
Current position on regulation of counsellors and psychotherapists
Counsellors and psychotherapists are not currently designated under the Health and Social Care Professionals Act 2005 (the 2005 Act). They are, however, subject to legislation similar to other practitioners including consumer legislation, competition, contract and criminal law. In addition, some practitioners are (or will be) subject to additional statutory restrictions. For example, the profession of psychologist is already designated under the 2005 Act and those psychologists who are counsellors and/or psychotherapists will soon be registered and regulated under that Act. Psychiatrists who practise psychotherapy are regulated under the Medical Practitioners Act 2007. Also, the Health Service Executive requires counsellor/ therapists working in the publicly funded health sector to have minimum qualifications set by it under the Health Act 2004.
The Health and Social Care Professionals Act 2005
Regulation under the Health and Social Care Professionals Act 2005 is primarily by way of the statutory protection of professional titles rather than restricting scopes of practice. The use of protected titles is restricted to practitioners granted registration under the Act. Registrants must comply with a code of professional conduct and ethics and are subject to “fitness to practice” rules similar to those applying to nurses and doctors. The structure of the system of statutory regulation comprises registration boards for the professions, a committee structure to deal with disciplinary matters, and the Health and Social Care Professionals Council with overall responsibility for the regulatory system. These bodies are collectively known as CORU.
The Act provides that the Minister for Health, after consulting the Health and Social Care Professionals Council, may designate a health and social care profession that has not already been designated if he or she considers that it is in the public interest to do so and if specified criteria have been met.
Background/Issues to be clarified
Counsellors and psychotherapists assist with people with psychological, emotional and or mental health issues. There is concern that, in many cases, there is no statutory oversight of their competence and conduct and that some practitioners lack the qualifications and professional training needed to work with such vulnerable clients.
The regulation of counsellors and psychotherapists under the 2005 Act would ensure that those registered would have minimum qualifications, that only registrants could use the title or titles protected under the Act, and that registrants would be subject to a range of sanctions (including suspension or cancellation of registration) in the case of a substantiated complaint of professional misconduct or poor professional performance.
A number of issues remain to be clarified. These include:
- Number of professions to be regulated (there is disagreement among professional bodies as to whether it should be one or two)
- Title(s) to be protected
- Grand-parenting qualifications to be set for existing practitioners
- Qualifications for future registrants
The Health and Social Care Professionals Council was consulted in accordance with the Act. The Council, in its report to the Minister (Appendix 2 below), considers that much work will need to be done to ensure that counsellors and psychotherapists are well prepared for registration. Unlike the other professions that are designated under the 2005 Act, the estimated 5,000 counsellor and psychotherapy practitioners do not form a cohesive professional body. There are 25 subgroups within the two professions, albeit the majority are in 2 bodies; the Irish Council for Psychotherapy – which has 5 discipline groups representing 10 organisations (claims approximately 1,250 members) – and the Irish Association of Counsellors and Psychotherapists, which claims 3,500 members.
The Council recommends a two-step approach – accreditation of voluntary registers of certain professional bodies (like in the UK) followed by the transfer of registrants on the approved registers to statutory registers under the 2005 Act. The Council also suggested further consideration of the outstanding issues (titles to be protected, number of professions to be regulated and the minimum qualifications to be required of registrants) before full regulation under the 2005 Act.
The Minister has given careful consideration to the Council’s views and accepts the challenges identified by the Council in moving towards regulating counsellors and psychotherapists under the 2005 Act. Rather than providing for a longer-term two-step approach, however, the Minister is proposing the designation under the Act of two professions (counsellor and psychotherapist) each with its own register. Those with the required qualifications could be granted registration on both registers.
The Minister is also proposing the establishment of one registration board for both professions that will establish and maintain the two registers. The new board will be asked to explore the issues involved and to advise the Council and the Minister on the timely regulation of the professions under the Act.
The level of grand-parenting qualifications to be set by the Minister on the advice of the registration board will determine the number of existing practitioners that will be granted registration. The registration board will set the approved qualifications for future practitioners. Standards for educational and training awards in counselling and psychotherapy were presented by Quality and Qualifications Ireland (QQI) in May 2014. These standards will assist in the process of assessing applications for approval of the relevant education and training programmes.
Title protection will also be a key issue from a public protection point of view. The legislation may need to ensure that those who are not practising a health profession within the meaning of the Act but who have occupational or professional titles that include the title of counsellor (financial counsellors, career counsellors, counsellors in the diplomatic service, for example) will not be subject to the Act.
Section 4(3) of the Act defines a health or social care profession as follows:
“A health or social care profession is any profession in which a person exercises skill or judgment relating to any of the following health or social care activities:
(a) the preservation or improvement of the health or wellbeing of others;
(b) the diagnosis, treatment or care of those who are injured, sick, disabled or infirm;
(c) the resolution, through guidance, counselling or otherwise, of personal, social or psychological problems;
(d) the care of those in need of protection, guidance or support.”
The regulation of a new profession under the Act is a lengthy process and involves the making of a number of statutory instruments by the Minister for Health and by the relevant registration board. Subject to the outcome of consultations, the following sequence of steps is envisaged:
- The Minister will make regulations designating the professions of counsellor and psychotherapist under the Act (the draft regulations will require prior approval of the Houses of the Oireachtas);
- The Minister will establish and appoint the 13-member registration board under the Act in accordance with Government guidelines on appointments to State boards;
- The registration board will be requested to advise the Council and the Minister on titles to be protected and on grand-parenting qualifications for existing practitioners;
- The Minister will make regulations protecting titles (subject to prior approval of the Houses of the Oireachtas) and prescribing the minimum grand-parenting qualifications for existing practitioners;
- In tandem, the registration board, with the approval of Council and following public consultations, will make a number of bye-laws to include qualifications (other than grand-parenting) bye-laws that will allow the establishment of its registers.
- The registration board will establish its registers and the two-year transitional period, after which only registrants will be permitted to use the protected titles, will begin.
Written submissions on the proposal to regulate counsellors and psychotherapists under the Act are accordingly invited by close of business 30 November, 2016.
Submissions by post or by email may be made to:
- Public Consultation, Professional Regulation Unit, Department of Health, Hawkins House, Dublin 2, D02 VW90
It is intended to publish submissions received on the Department’s website and all submissions received will be subject to the Freedom of Information Act 2014.
Late or anonymous submissions cannot be accepted.