Australia · Canada · New Zealand · United Kingdom
Governments in four countries are shortening training, widening who can do what, and changing how health professions are regulated. They call it "right-touch", "right-sized" or "top of scope". We track each reform, set out the evidence, and ask one question: has anyone checked that it is safe?
Every reform has its own page, with its status and the date we last checked it.
We quote each government's own reasons, and give the case for every change alongside the concerns.
Every claim is checked against its source before it is published, and labelled as evidence, survey or assertion.
The Psychology Board of Australia consulted on replacing the six-year route to registration with one five-year degree, removing the internship year and the national exam for domestic graduates, and will recommend the change to the federal government.
Ontario's psychology regulator voted to register master's graduates as psychologists and cut post-degree experience from four years to one. The proposal is now with Ontario's Health Minister; the title change would also need the legislature to amend the Act.
New Zealand's bill would let the Health Minister direct the health regulators on policy and let a ministerial committee overturn registration refusals. Parliament has since been dissolved for the November 2026 election.
Planned to grow to 10,000, physician associates came under GMC regulation in 2024. After coroners' findings and an independent review, the roles are to be renamed and restricted, but not abolished.
Counsellors and psychotherapists remain self-regulated with unprotected titles. National standards were published in 2025 and a consultancy is recommending a model.
An independent review found the scheme had "become too inward-looking, too fragmented, and too slow to respond to emerging risks and opportunities". Health Ministers accepted governance changes in May 2026 but deferred an integrated, risk-based framework for regulating all health professions.
The first major update to the psychology internship guidelines in over a decade took effect in December 2025, removing the case study requirement.
Following Harry Cayton's inquiry, BC cut its health regulators from 20 to 6 and created an independent oversight office. The new Act came into force on 1 April 2026.
Under a new federal interpretation of the Canada Health Act, medically necessary care that nurse practitioners, pharmacists and midwives provide in place of a doctor is to be publicly funded. The policy took effect in April 2026, with penalties from April 2027. Ontario missed the deadline.
Since January 2026, psychologists fully registered elsewhere in Canada can practise in Ontario for up to six months while they complete local registration.
Ontario pharmacists now prescribe for 28 minor ailments, after 9 were added on 1 July 2026; Nova Scotia pharmacists can prescribe for conditions including hypertension and type 2 diabetes.
Physician associates came under the Medical Council of New Zealand on 1 October 2026. Existing practitioners must apply by 30 November 2026.
Most new UK pharmacists now register as independent prescribers, and a 2025 law lets pharmacists authorise pharmacy technicians to supervise dispensing from December 2026.
Only qualified titles such as "clinical psychologist" or "registered psychologist" are protected in the UK. Much of the wider psychological workforce is assured through voluntary registers rather than a statutory regulator.
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An opinion piece by Ian Powell, former executive director of ASMS, arguing New Zealand's HPCA Amendment Bill gives the Health Minister too much power over independent health regulators.
Why it matters: Captures what we see as the main criticism in New Zealand: political control of regulators, rather than lighter-touch regulation as such.
The APS says it does 'not support the proposed five-year model proceeding in its current form', citing safety, the drop in qualification level, placements, and an undefined assistant role.
Why it matters: The APS's formal, Board-endorsed position on what the Psychology Board calls a once-in-a-generation reform of psychology training.
AAPi's summary of the Psychology Board's proposal: a single five-year degree to registration, no internship or national exam for domestic graduates, and a possible assistant exit. AAPi sees access benefits but is concerned about the drop to AQF Level 8.
Why it matters: A plain-English summary of the model the Board consulted on in April 2026. AAPi later said it does not support a five-year AQF Level 8 degree, and in September 2026 the Board said it will drop the assistant exit from the reform.
The Court of Appeal dismissed the BMA's challenge to the GMC's use of the term 'medical professionals' for both doctors and physician and anaesthesia associates in Good Medical Practice. A separate judicial review by Anaesthetists United, seeking national limits on scope of practice, was dismissed by the High Court in September 2025.
Why it matters: The courts found the GMC acted lawfully on both terminology and scope of practice. In our view, change will have to come through policy, not litigation.
A rapid review of the government's 2025 Putting Patients First proposals through the lens of equity and Te Tiriti o Waitangi obligations.
Why it matters: A critique, published as a Viewpoint in the NZMJ, of the 2025 Putting Patients First proposals, focused on what they mean for Māori health and cultural safety.
Ontario's regulator announces that its Board approved registering psychologists from approved graduate programs, cutting the experience requirement for master's candidates from four years to one, and recognising accrediting bodies outside the US. It says it will keep working on approaches that support 'fairness, labour mobility, and improved access to care'.
Why it matters: The regulator's own words. Quote this rather than second-hand descriptions of the change.
The current version of the framework. It keeps the six principles and eight elements, sets out a broad definition of harm (including psychological harm, financial loss and damage to trust), accepts that deregulation can be warranted where risk is well managed, and aligns with the UK's 'Smarter regulation' agenda.
Why it matters: The primary source. Worth quoting directly, including its own warnings about false assurance, and that regulation should only be called 'risk-based' where risks have actually been quantified and qualified.
An opinion piece by psychologist Monnica T. Williams supporting Ontario's proposal to let master's and doctoral graduates share the psychologist title, arguing that opposition from professional associations reflects elitism more than public safety.
Why it matters: A clear statement of the case for the change, from a supporter. Read it alongside the CPA/OPA joint letter for the case against.
The Board approved a registered Psychology Assistant role with safeguards: no diagnosis, a focus on mild or less complex needs, mandatory supervision and team-only practice. It received 441 submissions.
Why it matters: New Zealand's first registered assistant tier in psychology. Its safeguards are specific enough to monitor.
The New Zealand government's case for reform. It criticises 'unnecessarily high standards', long training and strict supervision, 'patch protection' and siloed regulators, and names associate psychologists among new professions it says regulators have been slow to adapt to, citing 'professional resistance or lack of direction from government'.
Why it matters: A strikingly direct statement of what the government believes is wrong with professional regulation. It mentions psychology once, naming associate psychologists as a new profession.
An independent review found the evidence on the roles weak and based on observational data. It made 18 recommendations, including renaming the roles 'physician assistant' and 'physician assistant in anaesthesia', and requiring a named supervising doctor for each physician assistant. The government accepted all of them.
Why it matters: In our view, a template for how a government re-tightens a role after scaling it ahead of the evidence.
Reviewed UK research on physician and anaesthetic associates published from 2015 to January 2025. Of 29 studies meeting its inclusion standard, none examined safety incidents and only one directly observed clinical competence.
Why it matters: In our view, a clear statement of the evidence gap: the authors warn that absence of evidence of safety incidents is not evidence that the roles are safe. Co-author Martin McKee was BMA president in 2022-23.
A senior coroner found that an ascitic drain, which a junior doctor had decided to place, was not clinically indicated. The physician associate who inserted it was unaware of local guidance, left it in for 21 hours and directed that it be clamped, which the coroner found was unwarranted. The report also raises the absence of a regulator at the time, title confusion, and a competency sign-off that covered only the technical skill of inserting the drain, not consent, risk factors or aftercare.
Why it matters: Its first concern was that there was then no regulator at all, so it does not show that proportionate regulation fails; its other concerns (training, supervision, the title, competency sign-off) remain relevant under regulation.
Harry Cayton, who developed right-touch regulation as chief executive of the UK's Professional Standards Authority, found the college met 17 of the 28 Standards of Good Regulation, and that many but not all of BC's health colleges showed 'a lack of relentless focus on the safety of patients'. He recommended fewer colleges, appointed boards and independent oversight.
Why it matters: Right-touch used to make regulators more accountable to the public, not to deregulate. It set off the reforms that led to BC's 2026 Act.
Two leading regulation scholars set out the built-in limits of risk-based regulation: it can miss cumulative, systemic and newly emerging risks, and depends on the regulator's ability to detect risk.
Why it matters: A theoretical lens. The paper is about regulating firms; applying it to hard-to-measure harms such as psychological harm is our interpretation, not evidence of harm.
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