Dáil debates

Wednesday, 5 March 2014

Topical Issue Debate

Health Care Professionals

1:45 pm

Photo of Dan NevilleDan Neville (Limerick, Fine Gael)
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I thank the Ceann Comhairle for selecting this topic which has been discussed on an ongoing basis since 2005. Currently, there are no regulations in Ireland for the registration of psychotherapists and counsellors and no State control over the qualifications held by those practising in the area. It is dangerous for untrained and unskilled people to probe a person's unconsciousness. They are dealing with human vulnerability and serious damage can be done to such delicate people.

The Health and Social Care Professionals Act 2005 provides for the registration of persons qualifying under the title of a designated profession for the determination of complaints relating to their fitness to practise. Psychotherapy and counselling were not included as the various organisations could not agree but then 22 of them set up the psychological therapies forum and came to an agreement on what to do.

On 20 February 2014, the director of the National Office for Suicide Prevention of the HSE, Mr. Gerry Raleigh, stated that people in distress should avoid these services because counsellors may not be fully trained or may not basing their counselling on best advice. He said it was important that a person seeking psychotherapy and counselling identifies processionals who are members of the psychological therapies forum, encompassing 22 professional organisations.

The psychological therapies forum said that it provides protection to clients but that 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 to practice accordingly without training or competence. Any person can put up a sign and say he or she is a counsellor or psychotherapist and charge €80 an hour to perform psychotherapy and counselling. It is extremely dangerous for such untrained people to do so.

I would like to give the example of two courses. One course ran for eight weekends leading to a diploma in eating disorders. One should be a professional to deal with that but I tested the system a number of years ago. A secretary, who had no qualifications or interest in any clinical, medical or psychological area, applied and was immediately welcomed on to the course and provided with a handwritten note inviting her to commence the course on the following Saturday. A course covering a number of weekends led to a higher diploma in suicide studies. It is highly dangerous for people to counsel those who have suicidal ideation after such a short course, when they are not fully trained. It takes four years plus of supervised practice to qualify as a psychotherapist. My objective is to include psychotherapy and counselling in the 2005 Act. It only requires a ministerial directive to do so and not legislation.

In response to me putting this to him, the Minister for Health, Deputy Reilly, when dealing with the Health and Social Care Professionals (Amendment) Bill 2012, stated:

However, I am supportive of addressing the regulation of counsellors and psychotherapists sooner rather than later. Replies to parliamentary questions and meetings with various delegations have been based on a policy position that statutory regulation for this profession would be considered for designation by regulation under section 4(2) of the 2005 Act in time to come when all regulations boards.....have been established......I share his concern about the lack of standards and the fact that people who taken courses over six weekends are calling themselves counsellors in the same way as those who have completed three or four year university courses or postgraduate degrees in psychology. We have to address this issue, but I hope the committee will give [time to do so].
He further stated:
While the [various counselling bodies] have now come together, they have as a consequence of speaking with one voice highlighted huge gaps in standards and we will have to do considerable work with HETAC to develop a shared standard. HETAC intends to provide us with a report on the matter in early or mid-2013 which will allow us to start immediately with the task of setting up a registration board for counsellors.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for the issue and giving me the opportunity to update the House on the ongoing regulatory programme being undertaken by the Department of Health, including the regulation of health and social care professionals. The 12 professions currently designated under the Health and Social Care Professionals Act 2005 are clinical biochemists, dietitians, medical scientists, occupational therapists, orthoptists, physiotherapists, podiatrists, psychologists, radiographers, social care workers, social workers and speech and language therapists. The structure of the system of statutory regulation comprises a registration board for each of the professions to be regulated, and a Health and Social Care Professionals Council with overall responsibility for the regulatory system.

Six registration boards have been established to date and the registration boards and their registers for the remaining designated professions should be established by 2015. The Minister for Health may, under the Health and Social Care Professionals Act 2005, designate by regulation a health and social care profession not already designated if he or she considers it is in the public interest to do so and specified criteria have been met.

While the immediate priority is to proceed with the establishment of the registration boards for the 12 professions currently designated under the Act, the Department is committed to bringing counsellors and psychotherapists within the ambit of the Act as soon as possible. A number of counsellor and psychotherapist national groups have come together as the Psychological Therapies Forum to advise as a single voice for the professions in so far as it is possible to do so. A number of issues remain to be clarified, including decisions on whether one or two professions are to be regulated, on the title or titles of the profession or professions and on the minimum qualifications to be required of counsellors and psychotherapists.

Quality and Qualifications Ireland, QQI, the successor to HETAC, has established a standards development group for counselling and psychotherapy which aims to establish standards of knowledge, skills and competence to be acquired by candidates for educational qualifications that will be required for careers in counselling and-or psychotherapy. This is an essential prerequisite to regulation of the profession. In addition, the standards of proficiency to be required of existing practitioners for registration will need to be established and the necessary qualifications prescribed. QQI has produced a draft report to which my Department furnished a response in November 2013. My Department will closely study the final QQI report as soon as it is available and will then engage with relevant stakeholders in order to work through the outstanding issues with a view to achieving regulation of counsellors and psychotherapists as soon as possible in the best interests of the protection of the public. Such regulation is also in the interests of the many fine psychotherapists working here. Their reputation is being damaged by those who are not qualified and will not qualify for registration once the regulations are in place.

1:55 pm

Photo of Dan NevilleDan Neville (Limerick, Fine Gael)
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I thank the Minister of State for her response. It is welcome that Quality and Qualifications Ireland, QQI, is setting down the standards which were promised in 2012 by the Minister for Health during the debate on the Health and Social Care Professionals (Amendment) Bill. I was told previously that regulation of these two professions would happen when all of the other professions referred to in the Act were regulated. I put it to the Minister of State that counselling and psychotherapy are as important as the other professions to which she referred. They were not included in the 2005 Act because when the legislation was going through the House, the then Minister of State at the Department of Health, former Deputy Tim O'Malley, said the professions had not reached agreement on the process of regulating counselling and psychotherapy. He argued that in such circumstances statutory regulation would have serious legal implications. While accepting the principle of the need to regulate these professions, he argued that he would wait for agreement to be reached before doing so. Agreement was reached several years later and a joint report by 22 bodies outlined how best to regulate counselling and psychotherapy. It was not done originally because of the lack of agreement among the professional bodies, but they stated in their report, submitted to the then Minister of State, former Deputy John Moloney, that it was necessary to have statutory regulation. There is no such regulation. I could set myself up as a counsellor in the morning and do untold damage. The Bodywhys organisation, for example, is extremely concerned about this because it has received several complaints from families with members suffering from eating disorders who received counselling which was highly dangerous.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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I could not agree more with the Deputy. I am aware that it was the lack of agreement, rather than a disagreement, between the various groups which meant that counselling and psychotherapy were not regulated. Now that there appears to be uniformity in thinking on the matter, what the Deputy is advocating is more pertinent than ever. We try to bring people along in formulating the basis for regulations and standards and are now at the point where this needs to be done as a matter of urgency. I know, from people I have met, about the damage that can be done by someone who is ill equipped and badly trained in the provision of counselling or psychotherapy services for people who are often in a very vulnerable position. We need to move quickly on this issue. It is not just about protecting the public which is the paramount concern but also about protecting the reputations of those who are well qualified and do an extraordinarily good job. We do not want everyone to be tarred with the same brush.