Colm Burke (Cork North Central, Fine Gael)
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The need for a discussion on the regulation of psychologists was precipitated by an RTÉ programme by Barry O'Kelly in recent days which raised serious concerns about what is occurring. There is no regulation or State registration. We set up CORU in 2007 for the regulation of healthcare providers and, unfortunately, psychologists do not at present come in under its remit. Clear evidence was provided in the programme of a person who presented themselves as having a qualification, who was employed by the HSE. The person was also registered with the Psychological Society of Ireland, although they did not have the required qualifications.

This issue goes back as far as 2012 and although we are now ten years on, we still do not have a system for the registration of the people who are supposedly investigating people who have a health issue that needs to be properly assessed and a report presented. We cannot allow this to continue. The issue must be addressed immediately. We must put the regulation in place, but we also need CORU to put in place a system whereby it will review all the qualifications and make sure that people are properly qualified. In the case presented by RTÉ, it was clear the person's paper qualification was fraudulent. The person operated as if they were qualified, but they were not and did not have any qualification. Could the Minister of State confirm to the House that immediate action will be taken to regulate this sector so that people can feel safe when a family member is assessed by someone who is putting themselves forward as being qualified?

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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Many of us watched the RTÉ programme that was screened on Monday night on the fact that psychology services in Ireland are not regulated. No State regulations exist, so anyone can set themselves up with fake documentation and claim to be a psychologist. The programme showed that this could be done very easily. We know of at least one person who did this.

This is very concerning because we have 12,000 children on a waiting list for assessment of need, and we have 4,300 children waiting to see a psychologist. The HSE is failing in its duty, as is the Department of Health, to provide those services in the public sector, which all of those children are entitled to. This leaves the system open to charlatans taking advantage of vulnerable children, vulnerable adults and their families, many of whom are at their wits' end because they cannot get the services that their child deserves and needs.

Children are suffering as a result and untold damage is being done. The waiting list and the inaction of the HSE over so many years are leaving the system open to anybody to claim to be a psychologist within the private sector, and that is adding insult to injury. Families should not be forced to go public, bare their souls and tell their stories but they feel they have no other way of getting the services their children need. That is not fair.

There are two issues, the first of which relates to the failure of the Government to regulate psychologists properly within the private sector. The Psychologists Registration Board was established five years ago and still has not determined what the regulations should be. Obviously, CORU cannot regulate until that work has been done by the board. The second issue relates to the significant failure by the HSE to provide the services the children require. Were the HSE doing its job properly and providing the services children need for both assessments of need and the follow-up interventions, parents would not be forced down the road of seeking private assessment and private intervention and would not face the possibility of being defrauded by someone posing as a psychologist.

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank Deputies Colm Burke and Tully for affording me the opportunity to address the House on this important issue, which is of great concern to the parents involved and has a big impact on their children.

CORU was established under the Health and Social Care Professionals Act 2005 to protect the public by promoting high standards of professional conduct, education and training among health and social care professionals. CORU’s regulatory model is based on the protection of title. Once a profession has been regulated, it becomes a criminal offence to use a professional title if the person is not a CORU registrant. Each profession has its own independent registration board, which is provided with statutory powers to implement regulation for that profession. Registration boards are responsible for establishing a register, approving and monitoring education and training programmes, and setting standards. Each board has 13 members and a lay majority.

Regulating a new profession is a complex and lengthy process, requiring careful consideration and preparatory work to ensure it will be effective in protecting the public. Psychology has been uniquely challenging due to the diversity of its specialisms and the fact there is no common education pathway or standards for entry to the profession. Entry to practice as a psychologist is currently defined by specialist postgraduate education. By establishing a common minimum threshold for entry to a single register for psychology, the Psychologists Registration Board, PSRB, would be creating a generalist role of psychologist, which currently does not exist. This would have significant implications, including on educational pathways leading to qualification.

The PSRB, established in 2017, has worked assiduously to develop standards of proficiency and criteria for education and training for the profession. These standards and criteria were the subject of a public consultation in 2020 that revealed significant concerns and a lack of consensus among the various psychology specialisms regarding how to proceed with regulation. Key areas of disagreement relate to the minimum level of qualification to be required, appropriate placement settings and the number of placement hours.

Having reached an impasse, CORU wrote to the Minister for Health on behalf of the PSRB in 2021 seeking guidance on how to proceed. The Minister replied to CORU in August 2022 requesting that the PSRB consider a dual-stream and phased approach to regulating the profession, which would allow the PSRB to prioritise regulating psychology specialisms that present the greatest risk to public safety, while simultaneously continuing to work towards the long-term objective of protecting the title of psychologist. On 3 March 2023, CORU wrote to the Minister on behalf of the PSRB with its recommendations for which specialisms should be prioritised for regulation. The Minister for Health is reviewing these recommendations with a view to progressing this work as quickly as possible.

Owing to the complexity of the work the PSRB must undertake, I am not, regrettably, in a position to say with any degree of accuracy when the profession of psychology will be fully regulated. I understand the PSRB will require a number of years to complete this work, but the Minister for Health and the Government remain fully committed to delivering regulation of the profession. I note the points Deputy Tully raised in respect of general care provided by the HSE, and what Deputy Colm Burke outlined in depth regarding CORU.

Colm Burke (Cork North Central, Fine Gael)
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I fully accept that the area is complex, and I have stated as much in discussions with Ministers over the past two days. Nevertheless, a danger exists, as was highlighted in the "RTÉ Investigates" programme. Somebody who is holding themselves out as having a qualification can give a written report that can be used in planning out the programme of care for a young person or child, and that is the danger. The PSRB was established in 2017, more than five years ago. We now need to move on. I do not want to have to come back to the House this time next year and raise the same questions. This needs to be given priority, with resources put in to ensure a structure of regulation and governance will deal with the issue. Psychology is too important to be allowed to go unregulated.

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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The Minister of State outlined that a public consultation had been held in 2020 and that it had been difficult to find consensus on a common education pathway and standards for entry into the profession. What I and many others want to know is why it has taken so long to hold that consultation. CORU, as he noted, was set up in 2005 and it has been almost six years since the Psychologists Registration Board was established. Why is the consultation taking place only now?

The Psychological Society of Ireland, PSI, also has concerns about some of the proposals and has stated it is imperative the title of psychologist become a legally protected title without further delay. It does not want clinical psychologists, for example, taking precedence over other specialisms such as child psychologists, because it believes that also would be open to abuse. Has the Minister for Health or CORU consulted the PSI on this issue?

Can I take it that the Minister and CORU will soon meet to discuss the matter? It has to happen soon because the delay in regulating the psychology profession is putting children at risk. It is harming them and leaving many behind.

Kieran O'Donnell (Limerick City, Fine Gael)
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Establishing a register for the psychology profession is a strategic priority to which the Minister for Health is fully committed. He has asked his officials, along with the PSRB and CORU, to progress this work as soon as possible to deliver regulation of this important profession. His Department and the two organisations are actively engaging on the matter.

On the issue of the public consultation, the PSRB was established in 2017 and works in what is, obviously, a complicated area. It worked on the standards and went to public consultation in 2020. While I do not know the precise details, I assume that took three years after the board had been formed because the area is deemed, by common consensus, to be a complicated one that requires careful consideration.

Fundamentally, this is a strategic priority for the Minister for Health to which he is fully committed, and he has asked his officials and the PSRB and CORU to progress this work as soon as possible to deliver regulation of this important profession. I will convey the Deputies' points and concerns to the Minister.