In its December 2023 consultation paper, the Board says that, historically, the Board made comments about scopes of practice that risked being construed as contradicting the fundamental principle that health practitioners must not practise outside their scope of practice. It says that (a previously composed) Board stated on its website that scopes of practice protect title but do not limit tasks, provided the individual psychologist is competent to perform those tasks”. This is not what the Board said on its website. Both this re-worded version of what previous Boards said, and similar variants communicated by the Board or its Secretariat in 2023, are misleading. They misquote what previously composed Boards said, they are taken out of context, and they either overlook or misunderstand how the scopes were lawfully developed and applied from 2004-2021.
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The current assertion
It may be helpful to address the current assertion by or on behalf of the Board that previously composed Boards’ ‘Important Clarification re Scopes of Practice’ was incorrect and did not align with what the Health Practitioners Competence Assurance Act 2003 says about scopes, or, as the Board now puts it in the consultation paper, “risked being construed as contradicting the fundamental principle that health practitioners must not practise outside their scope of practice”.
When the currently composed Board or its Secretariat makes the statement below or a variant of it:
“the statement [by previous Boards] that ‘practice is not restricted by scope, only title is restricted by scope’ does not align with what the Health Practitioners Competence Assurance Act 2003 says about scopes”
they are:
- misquoting what previously composed Boards said (previously composed Boards said “In short, practice is not restricted by scope, but by competence. Only title use is restricted by scope”);
- not providing the important surrounding context of what was said; and, importantly
- either overlooking or misunderstanding how the scopes were lawfully developed and applied from 2004-2021.
What the website statement actually said
This is what the clarification on the website actually said:
Important Clarification re Scopes of Practice
The Board has heard from psychologists and employers that vocational scopes are being used in ways that were never intended. Some employers and funders insist that psychologists hold a given scope as a condition of employment. While that is certainly any employer’s prerogative, it is important that all parties understand the following;
A vocational scope of practice does not “fence off” any exclusive territory (other than title use). Any psychologist can perform any activity, as long as they are demonstrably competent to do so, or are doing so under appropriate supervision (for example when training in a new area of practice). A vocational scope simply provides the practitioner with the right to use the scope’s title, and thereby clearly and simply signal to the public (or an employer) their competence in that scope.
In short, practice is not restricted by scope, but by competence. Only title use is restricted by scope.
All psychologists are ethically and legally bound to practise only within the bounds of their competence. Some employers and funders seem to assume that psychologists must have a specific vocational scope in order to competently provide the required service. Given the above clarification this can be seen to be untrue. For example, many highly competent and experienced practitioners working in the Family Court do not qualify for the Clinical Psychologist scope, but it would be a huge loss to the Court and to the families involved if these experts were denied work on that basis.
The Board has brought this clarification to the attention of major employers to ensure that the public continue to have good access to a range of experienced and competent psychologists.
Context is everything
If you look at section 8 of the Act, and ask in the abstract the question “Does section 8 say practice is not restricted by scope?”, you will get the answer “No, it doesn’t say that; it says a health practitioner must not act outside their scope of practice”. But previously composed Boards were not saying that section 8 says “practice is not restricted by scope”. They were not referring to the Act itself. They were referring specifically to the effect of their own vocational scopes, as developed by them and in the context of the general scope. Because the general ‘Psychologist’ scope is all-encompassing and all fully registered psychologists have or are deemed to have that scope, they were saying that:
- the extent to which a psychologist can perform particular psychological services depends on their competence; and
- the effect of a vocational scope is to restrict use of the scopes’ titles to psychologists who are registered in those scopes, so as to communicate the competence that these people’s university training gives them.
The way that previously composed Boards put it, expressly, was that “[a]ny psychologist can perform any activity, as long as they are demonstrably competent to do so, or are doing so under appropriate supervision (for example when training in a new area of practice)”. This was premised on the all-encompassing generality of the ‘Psychologist’ scope (which was, after all, worded very broadly and described as the general scope). And they said a vocational scope does not fence off any exclusive territory. Indeed, shortly before the bulk of the Act came into force, the Board explained in its August 2004 newsletter that:
On 18 September 2004, when the Act officially comes into effect, all psychologists registered under the Psychologists Act 1981 will be deemed to be registered under the general “Psychologist” scope of practice. You do not need to re-register under the new Act, or apply for a general scope of practice if you are currently registered.
And not long after that, the Board explained to or reminded the profession that “[p]sychologists who hold a vocational scope of practice are also deemed to hold the general scope” (see, for example, the Board’s website as at April 2005).
Context is everything. When read in context, previous Boards’ ‘Important Clarification re Scopes of Practice’ was not contrary to the Act. When read in context, including by reference to other contemporaneous communications with the profession, it did not risk “being construed as contradicting the fundamental principle that health practitioners must not practise outside their scope of practice” (as the Board now puts it in the consultation paper). Taking a contracted snippet of text and quoting it out of context can make it sound like that, but that is not what previous Boards did. It is members of the current Secretariat and the Board in its consultation paper who have done that.