AHPRA CEO: ‘The system isn’t working as it should’

Just weeks into his new role, the new CEO of the Australian Health Practitioner Regulation Agency (AHPRA) has vowed to make big changes to the medical watchdog and the National Scheme.
 
Addressing a National Scheme Combined Meeting last week, Justin Untersteiner outlined the concerns he has with the current regulation and accreditation systems.
 
Mr Untersteiner said while Australia has one of the world’s most respected healthcare systems, a ‘holistic review and major transformation of our notification system’ is his immediate priority.
 
‘I have been told that our system, which is designed to protect people, is at times causing harm,’ he told the meeting.
 
‘I don’t believe we can afford to make small tweaks – I think we need to pick the whole system up and rethink it.
 
‘There is enough evidence out there either through community and practitioner feedback, or in our own data that tells us the system isn’t working as it should.’
 
Mr Untersteiner said AHPRA must better understand the experience of anyone interacting with its scheme.
 
‘For there to be trust in our system, our notification system must be timely and efficient, it must be transparent with strong and clear communication, and it must demonstrate high levels of procedural fairness,’ he said.
 
‘It should also be empathetic and accessible.
 
‘I am not convinced that the current notifications end-to-end system is achieving these important outcomes, and as a result it is leading to a loss of confidence and a loss of trust in the scheme.’
 
Mr Untersteiner took over AHPRA’s top job in April when Martin Fletcher stepped down after 15 years in the role.
 
His latest comments come after hundreds of complaints were made about the regulator’s notification processes last year.
 
The National Health Practitioner Ombudsmen’s latest annual report revealed it received 435 complaints about AHPRA’s handling of notifications in 2023–24, with a rise in concerns about alleged failures to identify vexatious notifications.
 
Medical professionals’ feelings of distress upon receiving an AHPRA notification have also been well-detailed, with a study finding instances of suicide and self-harm by those under investigation.
 
Meanwhile, just weeks ago the Complexity review found a lack of clarity and direction within Australia’s healthcare regulation.
 
Mr Untersteiner labelled these findings ‘sobering’.
 
‘It paints a bleak picture of our performance in several areas,’ he said.
 
‘And a number of themes called out in this report are consistent with themes I have heard directly from those who I have been meeting with across the system.
 
‘I would like AHPRA to be seen as a leader in harm prevention. I want the professions and the community to have confidence in the work we are doing to improve the system.’

AHPRA CEO Justin Untersteiner.
 
RACGP President Dr Michael Wright told newsGP it is reassuring to hear Mr Untersteiner’s ‘open and frank assessment’ of how AHPRA is performing, including where it can be improved.
 
‘It’s really pleasing to see the new CEO recognising the problems that have existed within AHPRA and the potential negative impacts that notifications have on doctors,’ he said.
 
‘It’s so important that the system is procedurally fair, because we need to make sure that the system protects patients but also doesn’t harm people who have notifications against them.
 
‘Whenever you see a notification from AHPRA, most people get very concerned, and so it’s important that when AHPRA does communicate with people, it’s clear about that process.’
 
When it comes to ensuring Australia has ‘the right workforce in the right place’, Mr Untersteiner said AHPRA needs to accelerate accreditation reform.
 
‘There is a perception that we have moved too slowly, and at times made decisions that appear to be made in isolation without a deep enough understanding about flow-on consequence and risks,’ he said.
 
‘Yes, we are on track to implement the Kruk Review recommendations, and yes, I am very excited that we are seeing skilled overseas practitioners enter the Australian system now via our new expedited pathway.
 
‘But much more needs to be done and we must work together with the governments, colleges, accreditation bodies and other partners to address this issue.’
 
According to the latest data, this new expedited pathway for international medical graduates has seen 127 specialists registered in its first six months, including 125 GPs.
 
Mr Untersteiner also described the impact and growth of telehealth as ‘extremely positive’, before adding that, ‘like any major change it comes with risk’.
 
‘We have seen where telehealth models are misused and cause harm – for example, high and inappropriate prescribing of medicinal cannabis is a live case study of this risk,’ he said.
 
‘Likewise, the use of artificial intelligence (AI) in healthcare. AI can produce efficiencies, access to information and automation of low-risk activities – all of which are good.
 
‘However, AI can also introduce risks, such as information bias, privacy risk and misleading and inappropriate health advice.’
 
Finally, Mr Untersteiner said there is more AHPRA can do to improve cultural safety for Aboriginal and Torres Strait Islander people and ‘eliminate racism in the healthcare system’
 
‘There is much evidence that tells us racism remains too common in the health sector and that culturally safe practice is not yet imbedded system wide,’ he said.
 
‘We should ask the question about whether we are the regulator that protects all members of the community.’
 
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