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Health watchdog receives record number of AHPRA-related complaints


Morgan Liotta


23/11/2022 4:04:10 PM

Complaints about the regulator have increased by 42% in the past financial year, highlighting the toll its processes have taken on the medical profession.

Distressed phone call
AHPRA and the national Boards’ pandemic policy or response contributed to a significant rise in complaints received by the Ombudsman.

AHPRA’s impact on healthcare professionals is again under the spotlight, after the National Health Practitioner Ombudsman (NHPO) revealed a major jump in practitioner complaints about the regulator in 2021–22.
 
According to its annual report, the NHPO received 1593 approaches from health practitioners this past financial year, a record 65% increase from 2020–21. This included 731 enquiries and 823 complaints to the Ombudsman – representing a 42% increase from 581 in the previous financial year.
 
The majority (70%) of complaints received by the NHPO related to the regulation of medical practitioners, compared with 46% in 2020–21.
 
The NHPO report suggests that the pandemic has been a significant driver of the increased number of complaints, with many relating to GPs’ role regarding vaccination.
 
However, Dr Cathryn Hester, a member of the RACGP Expert Committee – Funding and Health System Reform, told newsGP the report also confirms overall concerns related to AHPRA among the general practice profession.
 
‘The findings of this report are yet another indicator of the significant strain that health practitioners have been under over the last two years,’ she said.
 
‘What is also apparent is that, in addition to the challenges caused by abrupt changes to policies around vaccination, the communication processes and timeliness of practitioner investigations still requires attention and is still a major concern for many healthcare workers.’
 
During this period, the Ombudsman’s office received an estimated 327 pandemic-related complaints, including 304 where AHPRA and the National Health Practitioner Boards handled a notification.
 
Handling of a registration matter accounted for 149 complaints, while ‘other complaint types’ made up 32 of those received, and 29 related to customer service or how AHPRA handled a complaint.
 
The NHPO suggests that other pandemic-related factors, such as burnout among health practitioners, likely contributed to the increases.
 
‘The increase in complaints we received this financial year appears to mostly have been driven by people raising concerns about regulatory responses to the pandemic, particularly the AHPRA and the Boards’ statements regarding health practitioners’ obligations around vaccination,’ NHPO and National Health Practitioner Privacy Commissioner Richelle McCausland said.
 
The most common pandemic-related complaints were:

  • mandatory vaccination and exemptions from mandatory vaccination – 177 (54% of complaints)
  • a doctor or health practitioner being ‘gagged’, ‘muzzled’, ‘silenced’ or ‘censored’, or patients not giving informed consent to vaccination – 65 (20% of complaints)
  • mandatory vaccination of health practitioners, including loss of work due to refusing to be vaccinated – 11 (3% of complaints).
The NHPO report states that these figures suggest that ‘directly or indirectly, 85% of the pandemic-related complaints we received concerned AHPRA and the Boards’ vaccination statements’.
 
AHPRA also released its annual report this week, revealing the regulator had received almost 10,900 notifications about 8146 medical practitioners nationwide – equivalent to 6.2% of the profession in 2021–22 – including 6176 notifications lodged with AHPRA about 4652 medical practitioners.
 
The majority (61.7%) were lodged by a patient or member of the public, and 44.7% related to clinical care.
 
Of the 5874 notifications that were closed, 58.2% resulted in no further action, while only 0.8% resulted in a practitioner having their registration surrendered, suspended or cancelled.
 
While AHPRA’s annual report made no mention of vexatious complaints, the NHPO reports that in 2021–22, it received 14 complaints of ‘potentially vexatious notifications’ – compared to 17 complaints of the same nature the previous year.
 
Despite the relatively small proportion, GPs have frequently spoken out about the debilitating impact vexatious complaints can have – both personally and professionally.
 
A recent newsGP weekly poll also suggests that the vast majority of GPs are sceptical of AHPRA’s ability to identify and respond to these complaints. Only 1% of the more than 1700 respondents believe that the regulator has sound processes for dealing with vexatious notifications, compared to 81% who do not think it is working effectively.
 
The poll was launched on the back of an RACGP call for feedback to an independent review launched by the Ombudsman and Commissioner in June this year into AHPRA’s implementation of a new framework aimed at identifying and dealing with vexatious notifications. 
 
The review’s report, and AHPRA’s response, is anticipated to be published in early 2023.
 
During the consultation process, the college received feedback from close to 60 members detailing their negative experience with the AHPRA process.
 
The regulator says it has ‘taken steps’ to improve its customer service over the past financial year, including updating its service charter outlining expectations for engagement, but Ms McCausland stressed that areas for improvement remain, including:
 
  • AHPRA’s delays in investigating notifications after immediate action has been taken against practitioners
  • the fairness of AHPRA and the Boards’ application of the English Language Skills Registration Standard
  • inadvertent disclosure of information about confidential notifiers.
 
‘My office is seeing the ongoing effects of the pandemic on community members and health practitioners, and we remain focused on assisting with concerns about how AHPRA and the Boards have handled matters, including notifications and registration matters,’ Ms McCausland said.
 
‘This financial year has presented our greatest opportunity to identify and address issues raised with us to create fair and positive change in the National Registration and Accreditation Scheme.’
 
She also noted that complaints are expected to continue to rise in the new year.
 
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AHPRA complaints process National Health Practitioner Ombudsman notifications regulation


newsGP weekly poll What is your chief concern with role substitution?
 
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5%
 
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6%
 
1%
 
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newsGP weekly poll What is your chief concern with role substitution?

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Dr Campbell Robert Crilly   24/11/2022 8:50:58 AM

Not surprising really. This last year I have seen increasing aggression from patients towards reception staff and doctors. Wait times being a source of aggravation and lack of availability for appointments and occasionally medical charges. The majority of the patients however have been understanding.


Dr James Roger Ewing Moxham   24/11/2022 10:38:32 AM

This document provides a fascinating insight into AHPRA's internal processes: https://www.ahpra.gov.au/Notifications/How-we-manage-concerns/Vexatious-notifications.aspx?fbclid=IwAR3V6wFJHrePzQDzcsGHhxdh3K4vOJJRkG_-yq9qVebtKkcBAcrV1brg4ds
In the document they reference is this gem: "It is also important to be aware of the common scenarios in which practitioners may seek to misapply the ‘vexatious defence’, including
• denial as a defence (practitioner claims the notification is vexatious to deflect blame)"
So you can't win!
I believe AHPRA is no longer fit for purpose. I think we had a perfectly good arrangement previously with state based medical boards and we ought to go back to that system.


Dr Peter James Strickland   24/11/2022 6:43:07 PM

AHPRA were the wrong way to regulate ethics in the medical profession in the first place. It was set up to give medicos Australia-wide registration, but it has been a disaster of expensive bureaucracy for everyone. Abolish it, and get rid of everyone who is employed by AHPRA, i.e who have charged exorbitant fees for medicos for registration each year, and then set up a bureaucracy that is distant and unsuitable for pragmatic control of the medical profession. State-based Medical Boards are the way to go -- easy to access, cheaper, fairer and quicker in settling disputes--no ifs or buts! Also, compensation should be available and payable for vexatious claims -legally and enforceable.


Dr Maureen Anne Fitzsimon   24/11/2022 9:43:51 PM

It goes both ways. My deceased husband complained to AHPRA that his CT abdo scan was reported as normal, when, in fact, it clearly showed a 32 mm pancreatic tail tumour which had not metastasised. APHRA found no fault with the radiologist.


Dr Anonymous Retiring   24/11/2022 10:56:32 PM

AHPRA is a huge failure in its 2 main reasons to exist (protecting patients and guiding doctors). It does neither.
It is a racist organisation clearly prejudiced against doctors of non white ethnicity.
Ahpra investigating officers have an attitude of domineering over and subjugating doctors, they act like Gestapo officers with impunity! Absolutely rotten organisation.
What is the mechanism to bring Ahpra officers to account? It does not exit in reality, unless someone is capable of taking them to litigation that costs hundreds of thousands$.