Former AHPRA CEO looks back on regulation challenges

The former chief executive of the Australian Health Practitioner Regulation Agency (AHPRA) Martin Fletcher has flagged growing ‘entrepreneurial and profit driven models of healthcare’ as key new areas affecting patient safety.
 
Writing in the Australian Health Review journal this month, Mr Fletcher looked back on his 15 years at the helm of the national health regulator, reflecting on the context behind its formation and the changing issues it now faces.
 
Acknowledging ‘opportunities for further reform’, he cited ‘the acceleration of telehealth, social media and augmented intelligence technologies’ as among the emerging challenges, alongside new areas of healthcare.
 
‘This can be seen in areas such as cosmetic practice and medicinal cannabis,’ he said.
 
‘Notifications and complaints can be a lag indicator in understanding emerging risks.’
 
Mr Fletcher also alluded to the way AHPRA handled notifications, which was frequently a focal point of strong criticism among GPs.
 
‘Being subject to a regulatory process can be distressing for both notifiers and health practitioners,’ he wrote.
 
‘In exploring these experiences and improving its regulatory processes, AHPRA has contributed to wider discussion about regulating for both patient safety and kindness.
 
‘However, the proportionality of regulation and where the public interest lies is debated, particularly for practitioners with a health impairment.’
 
Delving into the background of AHPRA’s formation, Mr Fletcher said the goal ‘was to develop a nationally consistent approach to regulation’.
 
He highlighted a 2005 Productivity Commission report which criticised ‘the fragmentation and inconsistency’ of previous registration arrangements and noted that AHPRA ‘replaced 85 registration boards, 65 pieces of legislation and 38 organisations across eight states and territories’.

‘In 2010, there were 530,000 registered health practitioners across 10 professions,’ he wrote.
 
‘There are now over 920,000 practitioners across 16 regulated professions.’
 
He also said the naming of racism in the National Law in 2022 had been ‘a powerful catalyst for action’.
 
‘This placed at the heart of the Scheme the importance of a culturally safe and respectful health workforce responsive to Aboriginal and Torres Strait Islander peoples and their health and that contributes to the elimination of racism in the provision of health services,’ he wrote.
 
Mr Fletcher left AHPRA in December 2024 to take up a post as chief executive of the Victorian Institute of Teaching.
 
Justin Untersteiner replaced him in the AHPRA chief executive role in April this year.
 
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AHPRA health regulation Martin Fletcher