News

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AHPRA proposes changes to health practitioner regulation

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AHPRA is seeking major changes to the way in which health professionals are regulated, following damaging reports about the regulator’s ‘toxic’ culture and concerns over its handling of sexual misconduct complaints.
 
According to a newly issued public release, the regulator is aiming to better protect patients from sexual misconduct in healthcare, ‘raise the bar for patient safety’, increase transparency and provide better support for victims.
 
The release also contained a ‘wider blueprint’ for reform that it has sent to all states and territories to provide a more transparent regulatory system ‘for patients and the public’.
 
A number of these measures require National Law amendments and cross-jurisdiction support, including:

• Strengthening the hand of patients and the public by increasing the role of community members in decision making committees about practitioner misconduct
• Seeking amendments to the National Law that would require tribunals to decide – in an open hearing – if practitioners who have had their registration cancelled can apply for re-registration
• The establishment of shared governance arrangements with Aboriginal and Torres Strait Islander peak bodies to oversee the implementation of the culturally safe notifications program
• Improved standards for those harmed by practitioners, via a Charter of Rights for those who have experienced professional misconduct by health practitioners.
• Including more information on the national register about practitioners with a history of professional misconduct in sexual boundaries cases, a change that would require Ministerial support

The announcement comes after Federal Health and Aged Care Minister Mark Butler ordered a ‘rapid review’ of the implementation of recommendations stemming from five previous Federal evaluations of the healthcare regulation environment since 2011. All of the reviews identified issues with the notifications process and pointed to a culture of bullying and harassment.
 
Meanwhile, CEO Martin Fletcher, who has led the agency since its inception in 2010, said the public expects that ‘only practitioners who are fit to practice’ will be registered and that regulators will take prompt action to protect patients from sexual misconduct by health practitioners.
 
‘We have learnt from history and made many changes to better protect patients from sexual misconduct over the past five years,’ he said.
 
‘But there is always scope to improve and do more.
 
‘Keeping the public safe is always our focus. We look forward to doing our part and working with governments and other regulators to get the job done.’
 
Other measures proposed by AHPRA in response to the recent reporting include:
 

• a public review of the Criminal History registration standard which applies to all registered health practitioners,
• expanded support and information service for victims and witnesses of sexual misconduct
• new research on the outcomes of sexual misconduct matters.

While the ABC and Nine Newspapers investigations have placed the spotlight on AHPRA’s dealings with the public, it has also been well established that practitioners likewise have little faith in the regulator’s ability to deal with complaints appropriately.
 
Appearing before a Senate Inquiry in July 2001, RACGP Expert Committee – Funding and Health System Reform Chair Professor Michael Wright aired a list of concerns regarding AHPRA’s processes and the impact these have on practitioners.
 
‘RACGP members continue to report issues around inadequate communication of the processes, lack of transparency of notification processes, lack of timeliness of decisions and – I think importantly – an inadequate recognition of the impacts that the AHPRA processes have on a practitioner’s mental health,’ he said.
 
‘We know that the overwhelming majority of complaints received by AHPRA are processed and assessed as not for further action. However, lengthy investing processes persist, and regardless of the eventual outcome, the processes can cause reputational damage and undue stress on the practitioner.’
 
AHPRA has previously taken some steps to limit the impact its notification process can have on practitioners, but RACGP member scepticism about the regulator’s fairness and effectiveness remains high, particularly in relation to vexatious complaints.
 
In a newsGP poll run last November, only 1% of 1705 respondents said they believed AHPRA’s processes for dealing with vexatious complaints are working effectively, while the college has also indicated that new guidelines aimed at identifying and dealing with vexatious complaints have done little to ease GPs’ concerns.
 
The RACGP has also criticised mandatory reporting laws that it says discourage GPs from seeking mental health care, along with legislation, passed in October 2022, that permits the publication of information regarding complaints before investigations are complete.
 
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AHPRA reform regulation

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