Psychologists, protected titles and regulation loopholes
The current edition of Private Eye (publication date 4th August 2016) outlines concerns about the regulation of psychologists. In particular, the journalists comment that; “providing psychologists don’t use one of the … so-called protected titles … any can offer their services without the need to be registered and regulated by the UK’s watchdog the Health and Care Professions Council (HCPC). Even if serious concerns or complaints are raised about them, they remain immune from investigation because they’re not registered”.
Many BPS members have raised this issue with me and my predecessors. So what’s the solution?
One option might be to press for regulation of the title 'psychologist'. That may well close the loophole to an extent, but it’s far from perfect. Protection of the public from charlatans is vital, but it may be seen as disproportionate to require all who call themselves psychologists to pay to register with HCPC. Our academic colleagues, who do not offer services to the public in that sense, may find that onerous. That solution would require legislative change and wouldn’t do anything to bring people legitimately using titles such as ‘psychotherapist’ or ‘cognitive therapist’ into the regulatory fold (and thereby help protect the public). The unscrupulous would merely avoid that new regulated title and would continue to mislead the public with new variations on the theme.
But we probably don't need that solution, as I believe the HCPC already has more power to act.
Under Article 39(1) of the Health and Social Work Professions Order 2001, it is a criminal offence for a person, with intent to deceive (whether clearly or by implication), to: – claim that they are on the HCPC Register; – use a title protected by the Order to which they are not entitled; or – claim falsely that they have qualifications in a relevant profession. It is clear to me that a person who uses a title such as 'consultant psychologist' is by implication claiming qualifications or professional status that they do not possess.
In other words, we do seem to have the legal powers to act, but seldom do. Perhaps a better question, then, would be to ask why HCPC don’t avail themselves more often of this route. It’s at least possible that we, as psychologists, are complicit assuming that there’s a legal loophole and not complaining.
At the same time, we need to get our house in order. Those of us who are legitimately qualified and experienced professionals who provide a service to the public but feel it is acceptable not to be registered because they don’t use a protected title should consider this as a call to action to reflect on their own accountability. The Society is improving its professional practice guidelines and could use them in collaboration with HCPC to outline more clearly the standards of professional behaviour that we value.
It’s possible that we also need more explicit legislation to clarify the language and allow prosecution more easily. This could also bring professions such as psychotherapy and cognitive behavioural therapists under the regulatory remit. The Government is beginning the process of consultation to consider major reforms that would unify the regulatory Councils. The aim is to improve the legislative approach to address these ‘regulated functions’ rather than merely ‘regulated title’ issues. We have quite a lot to benefit from such changes. We need to close loopholes, and we can learn from the other regulatory Councils. For example, the title ‘doctor’ is not a protected title (that is, instead, ‘registered medical practitioner’) and yet the public is relatively well protected from charlatans pretending “by implication” to be doctors in the lay-person’s meaning of the word. Having a PhD obviously wouldn’t protect me, for instance.
We should engage closely in the imminent consultation, and press for both a more intelligent approach to the regulation of our profession and sister professions, as well as for a closure of the ‘implied competence’ loophole, if necessary. It would be timely to look to improving investigatory processes, and to look at a more mature relationship between the BPS (which has a duty to promote the profession) and HCPC (with a more specific remit to protect the public) as they work together in the public interest. There is a lot to be gained from a unified approach to regulation in health and social care, and I believe that it would be valuable to extend statutory regulation to all the psychotherapeutic professions. However, in the meantime I think that there is a lot that the BPS and its members can do to ensure that those legitimately offering a service to the public ensure that they are registered, regulated and accountable, that they report cases where people appear to be committing offences by implied possession of qualifications they do not possess, and pressing HCPC to pursue prosecution using means that appear to be available by seldom used.