AHPRA releases draft mandatory reporting guidelines

Matt Woodley

12/09/2019 3:44:48 PM

The proposed changes are a result of legislation that was passed by the Queensland Parliament earlier this year amid protests from medical groups.

GP consulting a patient.
Critics fear mandatory reporting will stop medical practitioners from seeking help, particularly for mental health issues.

The controversial legislation forces doctors to report registered health practitioners, including those under their care as patients, to the Australian Health Practitioner Regulation Agency (AHPRA), should they believe the condition puts public safety at risk.
While only being debated in Queensland, Council of Australian Governments (COAG) processes for this type of legislation will see it applied in all other states and territories, outside of Western Australia, which has adopted vastly different laws.
The RACGP has consistently advocated for the adoption of the ‘WA solution’, which makes practitioners exempt from reporting doctors under their own care.
Critics of mandatory reporting, including the RACGP, have stated it could prevent healthcare practitioners, particularly those experiencing mental health issues, from seeking medical care due to the potential consequences of being reported by their treating doctor.
AHPRA has moved to quell these fears by releasing the guidelines for public submission, and is currently developing an information campaign to explain ‘What mandatory notifications mean for you’.
‘The revised guidelines and campaign aim to clarify the mandatory notifications requirements,’ AHPRA CEO Mr Martin Fletcher said.
‘The mandatory notification obligations are different for different groups, and for that reason it is important that we hear what you have to say about the revised guidelines.
‘The campaign will encourage practitioners to seek help for their health and wellbeing when they need it and improve understanding of the purpose and relevant circumstances for mandatory notifications.’
RACGP Queensland Chair Dr Bruce Willett told newsGP that while the wording in the draft guidelines is an improvement on the legislation passed earlier this year, he would still have preferred to see a WA-style exemption for treating practitioners.
‘The Queensland legislation talks about “significant risk of harm”, whereas the AHPRA guidelines refer to a “risk of significant harm”,’ he said.
‘That might sound like a small difference, but the point I made to the Queensland Health Minister is that [it’s just like] when I drive home every day – I am at significant risk of causing harm to people, just by the nature of the action.
‘It needs to be a risk of significant harm, and the threshold needs to be reasonably high.’
Dr Willett also said that while the draft document appears to create some additional clarity and security for doctors who regularly treat other health practitioners, he remains unconvinced it will be as helpful for those with less experience in the area.
‘It can be a difficult judgement call for treating practitioners with some of these issues. The way the legislation’s constructed, the onus of proof is on the treating practitioner to justify why they have not made a mandatory report, rather than why they need to,’ he said.
‘There’s a reverse onus of proof and the fear, of course, is that it may prevent practitioners from seeking help.’
Interested parties have until 6 November to make a submission as part of the public consultation process.

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Dr Faldt   13/09/2019 7:34:11 AM

The risk of a Dr even if depressed or a functioning alcoholic for example, actually being " a significant risk" to patients ( unless they do surgery) seems very low.
I imagine consultation notes about a college will become very lofty as anything disclosed will sit neatly in the head of the treating colleague and not in official documentation if the rapport is good.
I don't think much will come of this in reality. Very few drs ought to feel a worry of being reported from my point of view...

Dr Caroline Shipley   13/09/2019 10:25:14 AM

“Very few doctors ought to worry”..... tell that to the family of Dr Chloe Abbott.

Dr Peter j Strickland   13/09/2019 10:49:23 AM

One of the biggest risk to doctors etc. regarding their mental health is from APHRA itself. There is no doubt in my mind that this monolithic bureaucratic institution needs to be dissolved, and bring the Medical Boards back to the States themselves to determine medical registration and discipline problems. It would be easy for State Medical Boards to co-operate with doctors moving and working in other States, and the cost both financially and psychologically would return to "normality' again. APHRA was formed to overcome medical registration problems, and have an Australian-wide registration. Good idea, but a terrible and costly and expensive mistake, and it has failed as a pragmatic solution for doctors' registrations.

Dr Mattias Faldt   13/09/2019 1:08:11 PM

I agree with Dr Strickland.

How Chloe Abbott has anything to do with my comment earlier I do not see? I do not dispute the stress and angst we experience, I just don't see how I would likely see a reason to report someone for having these issues. They don't pose a risk to patients was my point.

Stuart C. Burton   13/09/2019 1:52:22 PM

Dr. Peter Strickland obviously has no idea how AHPRA works. It consists of a central Australia wide board which enables easy movement of registered practitioners throughout Australia. For someone like me who wroks throughout Australia in rural locums this is a boon. I would not like to go back to the old regime of having to register in each State. Day to day registration and disciplinary matters are dealth with by state branches of AHPRA which is no different to years gone by. Reverting to the old system would not solve the confidentiality issues which need to be further thought through in this discussion about Doctors' wellbeing. Let us not lose site of the fact that we need to be fit for purposein terms of the public's wellbeing and that is what AHPRA endeavours to do. If you don't like the system put your name forward to sit on your local state branch of AHPRA and or the College and make a difference

Ewen Cameron   14/09/2019 4:53:36 AM

Should we report the AMA for their support of some of the most liberal late term abortion laws in the world that will result in the virtual infantcide of thousands over the next 100 years and should we report all those who encourage voluntary assisted dying where without question people will be killed who should not have been.
Who are we to report them to?

Ewen Cameron   14/09/2019 5:13:34 AM

Anyone who doesn’t think APHRA isn’t more
impersonal and clumsy and cold and insensitive and less kindly then the old State boards hasn’t dealt with them both on these kinds of issues.
Yes, much loved and special and precious young doctors will die because of a clumsy big brother.
One good example of a form of reporting that all sane people will applaud though is the the registration of the NRA In America as a terrorist organisation in California.
Off topic I know but at last a ray of sanity in an insane situation and one example where people should be held to account by law for the public good in comparison to the politically correct and wrong mandatory reporting.