The Health Practitioners Competence Assurance Act ushered in the concept of ‘scopes of practice’. Regulatory authorities like the Psychologists Board needed to put 1 or more scopes in place for their professions. The Board consulted twice on its proposed scopes and they were notified in the Gazette in September 2004. The Board developed a model that had the “ability to protect the public, and still afford flexibility to ethical practitioners”, and it wanted to “ensure that there is adequate room to include all areas of psychology with a degree of risk to the public, whilst also providing protection for the most vulnerable groups in the public”. The general scope was defined very broadly, all psychologists were deemed to have it, and the titles of those with vocational scopes could only be used by them.
The Board explained in its newsletters how the Act and scopes of practice worked. In its August 2004 newsletter, it gave an overview of the Act as a whole. In its September 2006 newsletter, the Board included an “important clarification” on scopes of practice. The Board said it had been hearing from psychologists and employers that vocational scopes were being used in ways that were never intended. The Board explained that 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.” A similar message appeared in the Board’s July 2007 newsletter.
The original scopes of practice were the subject of a wide-ranging consultation in 2008-2009. When introducing the consultation paper, the Board observed that regulatory authorities had taken a range of approaches to scopes, with some prescribing a single scope, and others prescribing general scopes in addition to vocational scopes. The Board noted it had a range of feedback about scopes in the intervening years and that, coinciding with the Ministry of Health’s review of the HPCA Act, the Board has decided to review the scopes of practice. The Board received around 220 responses to the consultation. Substantially different views were expressed by the New Zealand College of Clinical Psychologists and the New Zealand Psychological Society. Ultimately, the Board decided to retain the scopes of practice as then currently gazetted.
In 2012 the Ministry of Health sought submissions from responsible authorities on the operation of the Health Practitioners Competence Assurance Act 2003. In its submission to the Ministry, the Psychologists Board explained how it had described its scopes of practice very broadly, how the Board had intended that the scopes would reflect and support the long-standing pattern of psychologists shifting or expanding into new areas of practice, how this was entirely possible under the Act, and how psychologists’ range of practice is subsequently constrained primarily by ethical and competence concerns, not by the breadth of their scope of practice
Between at least April 2005 to May 2021, the Board’s website frequently explained how the scopes of practice worked. In April 2005, the Board explained that psychologists holding a vocational scope are also deemed to hold the general scope, and that “vocational scopes do not limit practice – competency does”. In May 2005 the website changed a bit but said the same thing. From September 2012 to some time in 2014, the Board explained clearly that a vocational scope does not ‘fence off’ any exclusive territory (other than title use) and that any psychologist can perform any activity as long as they competent to do so or are doing so under supervision. Vocational scopes simply provided practitioners the right to use the scope’s title, thereby signifying their competence to the public. A revised version to the same effect appeared on the website from January 2015-January 2018. In February 2018 it had been removed but in March 2018 a watered-down version to the same effect reappeared and stayed there until at least March 2019. From April 2019 to at least May 2021 that statement had been simplified.
Over the years the Psychologists Board has made statements about its scopes of practice in its Annual Reports to the Minister of Health that are consistent with the statements made in its newsletters, on its website, and in other places. For example, in its 2010-2011 report, it said it had taken a very broad, flexible approach to defining the scopes, thereby minimising any workforce impediments, and that psychologists are free to practise in any area in which they are personally competent, but the public are also able to readily identify those practitioners who have completed specialised training in Clinical, Counselling, or Educational Psychology. These statements were repeated in the 2012-2013 report and the 2015-2016 report. In the 2017-2018 report the wording was tweaked slightly. An abbreviated statement appeared in the 2018-2019 and 2019-2020 reports, a very short statement appeared in the 2020-2021 report, and in the 2021-2022 report the Board said its current scopes of practice could provide greater clarity, and that review and clarification of scopes of practice was included in the Board’s programme of work through to the end of 2023.