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Published: 22/08/2002, Volume II2, No. 5819 Page 14 15

Strong views are being expressed during consultation on the reorganisation of the professions allied to medicine.Carol Harris listened in The future regulation of the allied health professions is attracting lively debate. A recent roadshow in Salisbury, organised by the Health Professions Council, had to start with a move to a larger room.

Once everyone had found a seat, continuing professional development (CPD) was the first topic discussed.

Under new rules now being debated, allied health professionals will need to show evidence of CPD if they want to remain on the council's register.

And that includes managers.

The council came into being on 1 April. It currently registers and regulates 12 NHS professional groups under the outdated rules of its predecessor, the muchcriticised Council for Professions Supplementary to Medicine.

New rules are being refined and developed through public meetings, letters and e-mails to the HPC. The consultation process runs until 30 September.

'We must go back to basic principles: we are here to protect the public and registration is given on the grounds of competence to practise, ' Professor Norma Brook, the council's president and a physiotherapist told the Salisbury meeting.

'I registered in the 1960s and since then nobody has asked me whether I was fit to practise. It is the same for everyone. This was clearly not satisfactory so the CPD requirement has been brought in.'

How that affects those with a more general managerial role 'is something we are debating...' Managers wanting to remain on the register may need to retain a clinical element in their practice.

CPD will also affect those returning to professional practice after a career break. This has been another hot topic at all the meetings so far.

In Birmingham, physiotherapist Peggy Palmer said that she had returned to practice two years ago, taking a course that was expensive and involved a long wait. She would be looking for greater flexibility for returners in future.

The council is looking for views on how CPD itself should be regulated. It wants professional bodies and higher education groups to develop courses.

'There are costs to CPD but there are also benefits in ensuring there is a good system, ' the panel told the Birmingham meeting.

The council, the professions and the NHS have three years to sort out the details before the new regulations link CPD to registration.

While there is professional support for expanding CPD, there was criticism of the HPC's approach to registration of allied health professionals who have trained overseas.

One of the government's favoured solutions to the problems of chronic staff shortages is to recruit from abroad. The time taken by the council to process applicants is a major obstacle.

As an independent body, the council receives no money from the taxpayer. Registrants will have to fund the improved services.

The fees are currently about£22 a year, but will probably increase to at least£65 a year.

Amicus union last week wrote to health secretary Alan Milburn opposing the '300 per cent hike'. Roger Spiller, head of health, says workers could boycott the fee.

In Salisbury, Marc Seale, the council's registrar, pointed out that the compulsory fee is tax deductible.

Support grades do not come within the council's remit yet. In Salisbury, ambulance paramedic Steve King said: 'We work with unregistered grades such as technicians and others who are not state registered and this is causing some problems.'

Professor Brook responded that the problem was not confined to paramedics: 'The government wants everyone to be registered, but how to do it - that we do not know yet. It is an issue which involves us, the General Medical Council and other groups, ' she said.

One of the spurs for reform of the allied health professions is protection of title. Arcane and archaic rules restrict the prefix 'state registered' to those on the council's register. But this has allowed free and full use of the terms such as 'occupational therapist'.The reforms are aiming for protection of common title, which restricts use of a broad professional title, for example, 'occupational therapist', to those on the register.

But a procedure has to be agreed so that those whose training is not up to the new standard do not have their livelihood taken away.

In Salisbury, podiatrist John Callum said he was concerned that this could lead to a 'dumbing down' process for access to the register.

Mr Seale said that if a new group was being 'grandparented' - as the process has been dubbed, because it is those who have been in the profession longer who tend to be affected - the council would not look at education and qualifications but seek evidence that people practised lawfully and safely.Any special arrangements will end in 2005.