Psychologists Nationalised in Australia: Registration Creates Greater Uniformity & Other Benefits
Healy, Imelda, The Journal of Employee Assistance
"... The new national registration has had a positive impact on efficiency and management in the delivery of services."
Psychologists in Australia can now practice with greater ease in any of this nation's states and territories. In addition there is an increased confidence in standards and practices, along with more open information and greater transparency, both for the general public and others utilising psychological services.
These changes are the direct result of the July 2010 registration of psychologists in Australia--a nationalisation, which, in turn, created the National Psychology Board. It is interesting to examine what led this complex process to be undertaken, the history and rationale behind this movement, and the impact for psychologists especially for those in the EAP sector.
History of Registration
Until last year each individual state and territory held the responsibility of registering all health practitioners, including psychologists. Registration requirements varied across jurisdictions. In fact there were more than 80 different health practitioner registration boards in operation throughout Australia. For psychologists there were eight registration boards, one for each state/territory:
* New South Wales (NSW);
* Victoria (Vic);
* Australia Capital Territory (ACT);
* Western Australia (WA);
* Queensland (Qld);
* South Australia (SA);
* Northern Territory (NT); and
* Tasmania (Tas).
Instead there is now one governing registration body, the Australia Health Practitioner Regulation Agency (AHPRA).
These changes date back to 2005 when the Commonwealth Government requested a study to examine issues affecting the health care workforce--and to make recommendations to ensure the continued delivery of quality health care over the next 10 years.
As a result of this study and subsequent suggestions, it was proposed that national registration and accreditation of health practitioners would provide improved safeguards for the public, deliver improved administrative efficiency and consistency by moving from a fragmented jurisdictional system to a single national system, and promote a more flexible, responsive and sustainable health workforce.
In 2006 an agreement was reached to establish a national
registration system for health care professionals, beginning with the nine professional groups registered in all Australian jurisdictions:
3) Nursing and midwifery;
7) Chiropractic care;
8) Optometry; and
9) Dental care.
In essence a single consolidated national registration and accreditation system--incorporating a new, national profession-specific board for each of the nine professions was developed. In 2008 the details of the model and structure of the new plan were finalized. (See the accompanying graphic on page 19.)
Moreover this plan had its roots in previous governing boards and legislation. The forerunner of the National Psychology Board was the Council of Psychologists Registration Boards (CPRB), which had been in operation in one form or another since 1985. In fact regulation of psychology in Australia dates as far back as 1965 with the Victorian Psychological Practices Act. The last jurisdiction to enact psychology legislation was the Australia Capital Territory (ACT) in 1995.
The objectives of the recent nationalisation registration, as set out in the Inter-Governmental Agreement, are as follows:
* To provide for the protection of the public by ensuring that only practitioners who are suitably trained and qualified to practice in a competent and ethical manner are registered;
* To facilitate workforce mobility across Australia and reduce red tape for practitioners;
* To facilitate the provision of high quality education and training and rigorous and responsive assessment of overseas-trained practitioners;
* To have regard to the public interest in promoting access to health services; and
* To have regard to the need to enable the continuous development of a flexible, responsive and sustainable Australian health workforce and enable innovation in education and service delivery.
Impact of Nationalisation
The primary purpose of the government is to protect the public and acknowledge that "psychologists can be potentially dangerous,"--wrote Associate Professor Brin Grenyer (2009) in an article that discussed the impact the National Psychology Board would have on Australia. Grenyer went on to highlight some of the scandals that resulted in changes to registration and ethical practices.
For example, the first psychology regulation closed down Scientology in Victoria, South Australia and Western Australia in the 1960s until it declared itself a "religion." In the 1970s practices at Chelmsford Hospital NSW, where patients died as a result of psychiatric "deep sleep therapy," led the NSW Minister for Health to state to Parliament in 1988, "That human suffering occurred is not denied, nor the fact that the Department of Health failed in its duty to protect patients from potential and real harm."
The subsequent Royal Commission and Burdekin Report into Human Rights and Mental Illness criticised psychology and spurred further reform of psychology regulation and a better health care complaints system (Grenyer, 2009).
There are approximately 25,000 registered psychologists in Australia, a quantity that is equivalent to the number of general medical practitioners. Each year, there are more than 100 complaints made by the public throughout Australia. In following the investigative process, it turns out that less than a dozen psychologists are deregistered for serious misconduct, while others only have conditions placed on their registrations.
The EAP Context
It's true that the main focus of a national registration system stemmed from a governmental decision to protect the users of psychological services. However, there is also an impact on organisations that deliver services. For most psychologists, national registration does not have any influence on day-to-day practice, other than changes in administration and annual cost charges.
However, for a large and successful national EAP provider such as PPC Worldwide, the new national registration has had a positive impact on efficiency and management in the delivery of services.
Some of these advantages include the ability to utilise clinical resources in a more efficient manner, matching specific areas with clinical expertise; provide greater opportunities for psychologists, including the establishment of national teams for triage, manager support, and after-hours response; and reduce administration red tape and create easier mobilisation of psychologists in times of need.
National teams, for instance, have provided psychologists with an opportunity to develop their own professional interests and skills in a specific area. Practitioners are no longer bound by the members of the state team that deliver a specific service; rather, practitioners can offer the best match for a more tailored delivery.
For example, if one state was running a particular project for an organisation, it can now go to the national team and invite psychologists from other states to participate. This method has worked very well for a recent health project whereby practitioners offer counselling support to people engaged in medical trials who are being treated for physical symptoms that may also have a psychological component.
Nationalisation also saves money for individual practitioners. In early 2010 registration in New South Wales (my place of residence), Victoria, ACT, and Queensland cost nearly $2,000. Since I am Irish, I also maintained my Irish Psychological Registration, which also cost approximately $600. However, this year, with a National Registration Board, my costs are now $180, and I can work across all of Australia!
Effect on Critical Incident Response
As of this writing, Australians are in the midst of what is being regarded as one of the country's greatest national disasters--the Queensland floods. Seventy-five percent of this land mass (larger than Germany and France combined) is now under water. There has been tragic loss of life, significant property loss, and disruption to normal work and life. Long-term costs to the economy have yet to be seen. However, predictions indicate that loss of business in the mining and agriculture sectors (the latter especially), will have an impact for years to come.
As an EAP provider, one of a practitioner's main areas of work is in response to Critical Incidents and Disaster Management. While allowances would have been made in a national disaster to deliver services in a state that didn't hold registration, in terms of dealing with the current disaster in Queensland, the recent nationalisation change has meant one less concern to contend with--which is always a good thing in times of crisis.
At present we have a team of interstate psychologists ready to be mobilised if necessary. However, other ways in which we can offer support to the local team is through the provision of normal services while they attend to disaster needs. For example, as the city of Brisbane is shut down due to the floods, we in other states can provide telephone counselling to people and thus free up the local team to attend onsite where necessary.
In general, the establishment of national registration has allowed greater ability to draw on a larger network of clinical resources from across the country. However, while PPC management has experienced advantages for our clinical and administrative team, there are individual practitioners who have not found this change to be of benefit.
For instance, practitioners in states where the state-based registration body recognized "specialist title" and have supervision requirements to match the registration of these "specialists," psychologists are disappointed that the process of supervision appears to have been lost with the change to national registration.
However, there is a three-year grace period for this system while the National Board considers the merits of this supervision practice for all college-endorsed psychologists. It is possible that the APS colleges will embrace this model.
In addition, intern psychologists are also finding significant uncertainty in relation to the process of post-graduation registration. This lack of clarity impacts their investment in the profession. Some intern psychologists have found the transition from state to national registration disappointing and frustrating, resulting in delays to being fully registered. It appears that these interns may have to complete another two years of supervision and provisional registration, which obviously affects their employment opportunities. While national registration occurred last July, these issues for students remain outstanding. This matter remains a potentially disappointing outcome to date. However, one hopes that a glitch in the process is something that will be overcome without disadvantage to our interns.
Generally speaking, EAP providers favor the benefits aimed at protecting the public from poor and questionable practitioners. Moreover, we at PPC have gained in both the clinical and administrative benefits that national registration has brought about.
There have also been unexpected benefits. One of the unforeseen and hidden advantages has been the feeling of being part of a national clinical team and organisation. The increase in the variety of work, national professional development and other opportunities for psychologists, has brought practitioners into contact with peers in other states. This has created a greater sense of community within the company. The ability to share knowledge, resources and expertise has enabled us to think about ourselves in a different light.
Fundamentally it has shifted the way in which we as an organisation not only deliver services, but in how we conceptualise and view ourselves. As a national provider, we at PPC WW are now truly national!
Grenyer, Brin (2009) "What a National Psychology Board will mean for current registrants, and what it might contribute to Australian Psychology." InPsych; Bulletin of the Australian Psychological Society, 31 (1) 15-15
Littlefield, Lyn (2008) "New national registration and accreditation scheme for psychologists." InPsych: Bulletin of the Australian Psychological Society, 30 (3) 7-9
Littlefield, L., Giese J., Stokes D., and Voudoris, N. (2009) "Registration of psychologists under the new national registration and accreditation scheme." InPsych: Bulletin of the Australian Psychological Society, 31.
By Imelda Healy, MS
Imelda Healy studied at the University College, Cork, Ireland, where she received her Master's in Counselling Psychology. She then practiced in both the public and private sectors for a number of years before working in the Irish EAP sector. Imelda began working as a consultant psychologist with PCC Worldwide in Australia in 2005. She is' now the Principal Clinician for NSW and ACT, where she manages all aspects' of clinical delivery as well as working closely with client organisations.…
Questia, a part of Gale, Cengage Learning. www.questia.com
Publication information: Article title: Psychologists Nationalised in Australia: Registration Creates Greater Uniformity & Other Benefits. Contributors: Healy, Imelda - Author. Magazine title: The Journal of Employee Assistance. Volume: 41. Issue: 2 Publication date: May 2011. Page number: 18+. © 2009 Employee Assistance Professionals. COPYRIGHT 2011 Gale Group.
This material is protected by copyright and, with the exception of fair use, may not be further copied, distributed or transmitted in any form or by any means.