Scopes of Practice : An opportunity for ownership

Beehive, NZ government building.

A guest post by Amy Ross

Amy Ross writes a response to John Darroch’s article   “New supplementary order paper fundamentally changes social work registration bill – and should not proceed”.

Any registration of any profession by the state carries risk. The state has an appalling history of allowing atrocities to be undertaken by ‘officials’ and ‘professionals’ with the backing of the law. Therefore, registration for social work should of course be undertaken with vigilance and we need to ensure that implementing any legislation is done by us and does not erode the core principles of social work or allow the state to define our theoretical or ethical basis.

The first iteration of the Social Work Registration Bill tabled as a last act by Anne Tolley and the National Government posed enormous challenges to the future of our profession. The Social Work Community swung into action. There was a huge number of submissions (see the PSA one here) and an open letter petition that caught the attention of the new Minister Carmel Sepuluoni.

There were two core issues for the Social Workers Action Network (as articulated in more detail in our submission). One was the circular and meaningless definition of social work the original bill provided which created ability for employers to define social work themselves. The PSA and ANZASW both received many calls from employees who had already had their job title changed by their employer to remove the title ‘social work’ in anticipation of being able to have their social work employees do the same job without calling them social workers; or paying or recognising them as such.

The problematic reporting of misconduct to the board was another key issue for the PSA. The way it was worded created a risk that more organisations would use the Social Work Registration Board as a defacto HR department, calling into question the future security of basic employment rights for social workers in the workplace.

The PSA joined the voices of our members with many other social work organisations in the Social Work Alliance, including ANZASW, The Tangata Whenua Social Work Association, The Council of Social Work Educators; DHB social work leads and the Social Service Provider Association (amongst many others) to influence change. It was an almost unprecedented cooperation between social work advocates and community leaders and we were able to influence a number of positive changes to this dangerous bill in the form of a supplementary order paper (SOP)

John Darroch’s article calling out this SOP as making things worse and arguing for the bill to go through to vote in its original form is disappointing after such a widespread, community led response. The SOP is certainly not perfect (no legislation I have ever seen is) but if the bill was to go to vote in its original form this would undo significant cross sector work. The early National Party bill was full of attacks on the profession and also technical problems, of which I have only highlighted two.

The concern expressed in the aforementioned article about scopes of practice is valid in that it is true we don’t know what will be in them yet as they are not in the legislation. This is purposeful as we don’t actually want them to be in legislation where they would be unable to be changed or influenced by our community as we develop our own understanding of practice. We don’t want to have to go cap in hand to the Government of the day to change and develop social work practice.

However it is inaccurate to say that the scopes will be written without the community or by the board alone. The bill requires involvement from stakeholders in the development of any scopes of practice. The SWRB is just the coordinating body which holds the pen. Social workers must claim this opportunity and be involved in every debate, every nuance of the scope discussion. I know that when the SWRB put out their first iteration of a general scope of practice PSA members provided scathing feedback and as a result of this feedback, (amongst other community feedback) it was dramatically changed. This process could be a thousand time more robust, if we seize the chance and get involved. The risk of the scopes not reflecting reality can only come to pass if we as a community do not stand up and make sure that they do. The debate about how many there ultimately are is still one we have a chance to have robustly as a community.

It is also not accurate to say that scopes of practice will necessarily mean that people will have to undertake expensive and inaccessible post graduate qualifications as a matter of course or that they must register multiple times in complex siloed systems. The course of the scopes of practice is likely to be the same as the Health Practitioners Competency Assurance Act upon which it was based. This works effectively for many professions that social workers regularly intersect with.[1]  The core general scope of practice that defines core competencies, responsibilities and qualifications for social work will be critical. This must in my view be based on our strong core ethics and values as is the International Definition of Social Work. Having a strong core scope of practice will prevent employers cherry picking what they call social work or employing social workers to do social work in jobs that simply are not named as such. It removes the ability for them to say social work is “vague” or argue that because that the words ‘social work’ are not used that it is therefore not a social work job.

When it comes to specific scopes of practice for a specific area, (such as those in health) the purpose is not to create a whole lot of bureaucratic obstacles and multiple points of registration. Certainly, none of the many social work organisations pushing for change would ever have argued for that. A scope of practice does not necessarily make a task or responsibility exclusively yours nor does it have to be a specific list of restricted tasks. Just as in a health setting where scopes overlap all the time (for example a Nurse Practitioner and a Doctor in their ability to prescribe medication or Occupation Therapists and Nurses in their ability to assess) the same will be true for different areas of practice in social work. All social workers must engage with a person holistically as that is a core element of our praxis.

Different scopes of practice can essentially be defined as having two clear purposes:

  • Articulating the competencies and responsibilities of social work in a particular field to help delineate and protect the social work role, something we have already seen under attack with the rise of “social work assistant roles” or “case workers” etc which can act in effect as unqualified, unsupervised, low paid workers doing a social work role. We heard a lot throughout the process of fighting the original bill that social work is difficult to define (Cabinet paper, Regulatory Impact statement, select committee report, MSD advice to select committee). This becomes problematic in multi-disciplinary environments where social work ends up with the “everything else that nobody else wants” or so poorly understood that the real value social workers bring is ignored or distorted.
  • Allowing different areas of the social work community to build on the general scope of practice to refine and add to the things important for their sector. NGO social workers don’t want Oranga Tamariki to define social work for their sector, Health don’t want to be defined by NGOS and so on. The ability to develop (over time) specific scopes of practice should absolutely be monitored but can also be an opportunity for us to get some real control back and ensure social work doesn’t become simply ‘child protection’ as it is often seen. There is absolutely no reason that a Kaupapa Maori scope could not be created which could challenge many conventional notions of qualifications and practice for example. We will need to be vigilant against any creation of hierarchies, deliberate or inadvertent, through this process but again does offer an opportunity to allow each field of practice to “come out into the sunlight” so to speak.

I hold no illusions about not having to fight to prevent the cult of managerialism and neoliberalism creeping into the wording of scopes of practice or about the need to fight against the reality of austerity cutting our ability to practice or resource ongoing learning deeply. However the coherent community organisation around this bill shows me that we are ready to take on the task of being involved in any scope development and make it truly our own. It will not be without challenge. But implementation of any registration would pose some challenges, particularly in a neoliberal environment. This bill is an opportunity as I see it, an opportunity which will be well and truly gone if the bill were to proceed in its original form, leaving us dependent on the goodwill of employers to retain any social work jobs.

[1] Indeed during this process the HCPA Act was getting reviewed and MSD officials were able to have conversations to understand the learnings of this review so they could be included in any replication of the HCPA process

 

5 thoughts on “Scopes of Practice : An opportunity for ownership

  1. The Social Workers Registration Legislation Bill – Supplementary Order Paper
    The Social Workers Registration Legislation Bill was introduced to Parliament 9 August 2017 and passed First Reading 17 August 2017.
    There were a number of issues with the Bill, the most significant being that practicing as a social worker or being willing to practice as a social worker was defined as being “employed or engaged by another person in a position that is described using the words social worker”.
    The ANZASW database has 110 role titles occupied by qualified and registered social workers that are not described using the words social worker. Almost half of the members are working in these roles. Under the Bill as written, these people would not be deemed to be social workers and would therefore not have to be registered. It is appropriate to note that people practicing social work who are not registered fall outside the remit of SWRB. This means that these practitioners are not externally regulated, and nor can they be held to account for their practice.
    Effectively the Bill handed the employers the responsibility for determining who was, and who was not a social worker. After First Reading members were frequently calling ANZASW to say that their position had been restructured, the work remained the same, the people using the service remained the same, but the role was no longer called ‘social worker’ and payment of registration / Annual Practicing Certificates, professional development and supervision was removed from individual employment agreements.
    ANZASW made a detailed submission to the Social Services and Community Select Committee following extensive consultation with members. You can read the submission here.
    Following the Social Services and Community Select Committee hearings the Bill included another worrying amendment – that a person was not practicing as a social worker if social work was one of the suite of qualifications required for the role and that person did not hold themselves out to be a social worker.
    It should be noted that over 70% of the submissions to the Social Services and Community Select Committee were from the social work profession; those submissions “expressed a desire for the inclusion of scopes of practice as a means for setting the parameters of social work, and potentially helping to better define social work. Many of those submissions also promoted the use of text from the HPCA Act as a model for the operation of any proposed scopes” .
    ANZASW along with Social Work Alliance developed an effective relationship with officials in MSD to develop a SOP to create a Bill that was fit for purpose. The Social Work Alliance represents a wide group including the regulator, the professional bodies, educators, employers, the union, health social workers and large employers of social workers.
    In the context of both the overwhelming support for a scope of practice approach to registration in Select Committee submissions and the feedback received by the Alliance members from their constituents, the Alliance advocated for and successfully worked alongside with MSD to develop a scope of practice approach to registration.
    The Social Workers Registration Board produced a Social Work – General Scope of Practice in July 2017. (see http://swrb.govt.nz/download/when-an-annual-practising-certificate-is-required/). It is expected that this scope will be part of the discussions with the profession about a future scope during the two-year transition to mandatory registration. The Bill clearly requires SWRB to consult with social workers, employers of social workers and others affected by the proposed scope including the professional associations and educators.
    For practitioners the scope of practice provides a mechanism to limit the ability of employers to hire people with social work qualifications but describe the role as something else in order to avoid costs associated with registration and as a means of avoiding a professional wage.
    ANZASW welcomes the Supplementary Order Paper and the positive changes if adopted that it will make for the profession.

    Shannon Pakura- ANZASW Board member-027 631 2655
    Lucy Sandford-Reed- CE- 027 349 0190

    1. One of the concerns I have with this statement is that it refers to a singular scope of practice which will be applied to social work.

      The SOP explicitly refers to a range of scopes which are to be created – with the SWRB having the power to decide whether a social worker has the “prescribed qualifications” to practice within a particular scope.

      As with the majority of submitter, I support the inclusion of a singular scope of practice to address the points you raise above. I support the proposal contained in the ANZASW’s submission as to how this could be done.

      I believe scopes (plural) will either lead to a tiered system as with nursing, or that the profession will be split into sub-domains based on area of expertise. I do not believe that most social workers understand the implications of this – or that the profession has adequately traversed the risks involved in this approach.

      I still have significant concern about what splitting the profession into a range of scopes could mean. I am personally uncomfortable with legislation which commits the profession to this path. However, I recognise that the ANZASW is a democratic organisation and I appreciate the explanation as to why the ANZASW supports the approach laid out in the SOP.

      I am also genuinely relieved to know that the ANZASW (and other organisations) will be pushing for scopes which reflect the ethics, history, and reality of social work practice.

  2. I hold the view that professional registration of social workers should only be considered if the applicant has completed a social worker qualification. I cannot be a registered Nurse without the correct qualification or a Teacher etc. It would be unsafe for me to think I could. So much learning takes place when you study, and mind shifts are unavoidable. I am concerned that the profession is already struggled for its place professionally and this I believe is largely due to the unsafe past practice of others that are not of the same skill set. Users of social work services have a right to be safe and not be placed at risk from workers that are unskilled in this area and working from a personal lens of experience. Section 13 of I believe should be phased within a year.

  3. Hi Amy, thanks for this response.

    I appreciate that it is detailed, addresses many of my concerns, and explains the process by which the approach laid out in the SOP was come to. I also appreciate the range of groups that have been involved in this – something I had not been aware of.

    I take issue with you stating that it is disappointing that I wrote my post given the community led response that had led to the SOP.

    I follow politics and social work pretty closely and I had no idea about this SOP. I appreciate that there were press releases and documents put out by the profession regarding it, and perhaps I should have known about these. This was something I had been concerned about – that I had missed some widespread consultation and discussion of the SOP. Over the past few days I have talked to numerous social workers and academics, and none of them knew this was happening, so I don’t think I was alone in my ignorance.

    Upon hearing about the SOP on Friday night I began looking for as many sources of information as I could, I googled various terms, looked on the ANZASW website, read the report to cabinet, and read as many submissions on the original bill as I could. I spent most of the weekend doing so.

    Despite this reading I couldn’t find any public documents which clearly articulated the risks that this proposed approach to social work regulation may pose. The only professional sources of information I could find were positive, and did not provide much detail.

    It was against this background, and out of deep concern for the profession that I wrote the post I did. As a social worker engaging in critical analysis of social policy, and informing the public, are core ethical responsibilities – and they are ones which I take seriously. I appreciate the tone of my post was critical – and I apologise for any hurt this may have caused. If I had more time (a period of weeks or months) I would have written a fulsome piece covering all the possible strengths of the approach laid out in the SOP – and I would have reached out to people in the profession to find out who in the profession was behind it (something which was difficult for me to figure out).

    Given that the SOP is being considered on Wednesday I thought it necessary to write the piece I did – to immediately and clearly highlight potential risks – many of which you have acknowledged are valid.

    I understand and appreciate the hard work which you put into the profession, and due to your post I better understand the reason for the approach this SOP takes.

    In solidarity.

    John

  4. I am a Registeted Medical Practitioner buy as am retired I did not reapply for my APC, and could not meet all required CPD points anyhow while retired.
    I had done separate non- medical training as a Counsellor, and, as a psychotherapist.
    Medical Council said I could not volunteer in any capacity, as I would use medical info in my head, and as someone may complain to them re me, even if I was not helping as a Dr- volunteer.
    So registration can leave one in limbo when could have provided needed help alongside a NGO

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