AHPRA should not handle minor complaints: Review

Minor complaints against GPs would no longer be handled by the Australian Health Practitioner Regulation Agency (AHPRA) under reforms proposed in a newly released review.
 
That is among the 26 recommendations put forward within the ‘Transforming Health Professions Regulation in Australia’ report released last Friday, the culmination of the so-called ‘complexity review’ set in motion last year.
 
If the recommendations are put in place, notifications against health professionals will ultimately all go through a ‘single front door’ in each jurisdiction, with only more serious allegations raised to AHPRA.
 
The reforms proposed in the review, which was led by former New South Wales Health Care Complaints Commissioner Sue Dawson, are described as an ‘ambitious transformation program’.
 
They also recommend the AHPRA Board ‘immediately improves timeliness and quality of investigation processes and decision making and the availability of clinical advice across all regulatory functions, with specified actions to achieve this’.
 
An audit of all AHPRA investigations that have been open for more than a year should also take place within three months, its authors stated – while also noting growing dissatisfaction with processes for filtering out vexatious or frivolous notifications.
 
‘Practitioners understandably object to the frequency with which notifications are made and subject to lengthy consideration even when in 85% of cases there is no further action required,’ the report states.
 
RACGP Vice President and WA Chair Dr Ramya Raman said the notifications process had long been a concern.
 
‘Many GPs want to see significant improvements to the complaints processes, and we welcome the publication of detailed recommendations for how that should happen,’ she told newsGP.
 
‘For years, we have voiced serious concerns about the impact of vexatious complaints and delays in the resolution of notifications – and it is pleasing there has been progress in timeliness recently.
 
‘We will be looking closely to see that any actions prompted by the report do reduce delays and minimise distress as promised.
 
‘It is essential the system is fair and responsive for people who are under investigation and acknowledges the stress and harm that it can cause.
 
‘We will consider each of the suggestions in the report in detail and continue to advocate for the clearest possible regulation that both protects patients and minimises the impact on our members.’
 
The independent ‘complexity review’ analysis began in April 2024, with detailed policy suggestions released in a 122-page document earlier this year after an initial consultation paper.
 
‘It would be hard to overstate the breadth and depth of dissatisfaction with the current complaint handling and notification processes,’ that document stated.
 
‘These processes are not meeting the basic expectations of health practitioner regulation in Australia. This is an equally acute concern for practitioners, consumers and policy makers.’
  
It criticised ‘a lack of clarity’ and the absence of ‘an overarching framework for the regulation of health professions’, as well as noting the absence of any ‘shared agreement about what is most necessary and important in health professions regulation, at any point in time and over time’.
 
In an initial submission for the review last year, the RACGP said it ‘supports measures to simplify or streamline complaints handling in principle’, but would need more information about the costs and benefits of a single front door process.
 
The college also opposed a proposed extension of the Ministerial Council’s power of direction to apply directly to accreditation entities in addition to National Boards due to ‘the risk of fragmentation between states and territories’.
 
Instead, the RACGP suggested that using expertise within relevant authorities such as AHPRA, the Australian Medical Council and medical colleges, would lead to better policy and patient outcomes.
 
However, the report recommended extending the Ministerial Council’s power of direction.
 
In a response to the report’s release, AHPRA said it is carrying out its own end-to-end review of the notification system and confirmed the introduction of so-called ‘Pathway Navigators’ to guide consumers through the complaints process, which was one of the review’s recommendations.
 
The regulator also said it had reduced average assessment times for complaints ‘to the lowest on record while handling more matters than ever before’.
 
AHPRA CEO Justin Untersteiner said the agency would respond to the report and work with ministers and other health departments to carry out reforms, including measures to ensure the regulator had the right skills, roles and tools to be a contemporary regulator. It would also collaborate to ensure a timely and transparent complaints system, he said.
 
The review emphasised that its measures would support the National Registration and Accreditation Scheme to develop ‘a flexible, responsive, and sustainable Australian health workforce’.
 
‘It is crucial that the RACGP has a seat at the table, and that general practice standards and expectations are included in discussion about national workforce planning,’ Dr Raman said.
 
The review ultimately recommended against setting up a national complaints handling body, which it said would require ‘an unavoidably lengthy, elaborate and costly process’, and would be ‘hampered by uncertain outcome’.
 
‘The most likely outcome would be one set of complexities being replaced with new complexities,’ its authors wrote.
 
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