IMG assessment push softened in final Kruk Review

Comparability assessments of overseas doctors will likely remain in the hands of specialist colleges – including the RACGP – provided agreed timelines are met, a revised review of international healthcare worker recruitment has said.
 
An interim report of the ‘Independent review of Australia’s regulatory settings relating to overseas health practitioners’ had said such assessments should shift to the Australian Medical Council (AMC).
 
Published in April this year, it said the change would ‘drive greater consistency in performance and outcomes and reduce costs’.
 
However, it generated strong pushback from RACGP President Dr Nicole Higgins, who said sidelining specialist colleges from the accreditation process would increase patient risks.
 
She cited the series of deaths at Bundaberg Base Hospital around 20 years ago linked to US-trained surgeon Dr Jayant Patel, who was employed after specialist registration was ‘largely circumvented’ according to the Queensland Public Hospitals Commission of Inquiry.
 
The final report, which was published this week and is widely known as the Kruk Review after its author ex-senior bureaucrat Robyn Kruk, watered down the recommendation to say it should take place only ‘if expectations are not met within agreed timelines’.
 
It also notes the work of the National Health Practitioner Ombudsman (NHPO) to review accreditation procedures.
 
‘In light of the NHPO recommendations, and given stakeholder feedback, the immediate focus should be on streamlining processes, removing duplication and providing greater support to specialist comparability assessment to ensure more timely decision making and consistent outcomes,’ the report states.
 
It is among 28 recommendations, which cover five broad areas including improving the experience of applicants, fast-tracking registration pathways, improving workforce planning, increasing flexibility while supporting safety, and enhancing the performance of regulators.
 
Earlier this week, Prime Minister Anthony Albanese announced an extra $1.2 billion in funding, endorsed by National Cabinet, part of which he said will go towards putting Ms Kruk’s recommendations in place.
 
Dr Higgins said she remains ‘strongly opposed’ to the possibility of AMC involvement but welcomed the release of the report overall.
 
‘Addressing GP workforce issues is essential in ensuring that all patients in all corners of Australia can access the care they need when they need it,’ she said.
 
‘The report’s number one recommendation on streamlining processes across agencies and regulators so that applicants only need to provide information and meet requirements once is just what the doctor ordered.
 
‘If we don’t act in this space, more overseas doctors will opt for other countries and we will miss out.’
 
A Senate Inquiry earlier this year heard of the discrepancy between recruiting an International Medical Graduate (IMG) into the workforce in New Zealand. The Primary Care Business Council said the task takes three months and costs $5000 on average in New Zealand, compared to 14 months and $23,000 in Australia.
 
Among Ms Kruk’s recommendations are eight priority measures she suggests can be taken immediately.
 
These include a single portal for applicants to prevent duplication across agencies, suspending the need to advertise for domestic applicants in areas of shortage, and raising the age exemption on skilled visas to 55.
 
Expediting registration in shortage areas, bringing in more recognition of skills and experience, and lowering English language testing requirements are also included.
 
Dr Higgins said that the college will carefully consider all 28 recommendations.
 
‘Boosting workforce numbers is crucial; however, we must proceed carefully on several fronts,’ she said.
 
‘While we have committed to simplifying and streamlining our own processes to make it easier to get overseas doctors living and working in communities around Australia, maintaining safety and quality is a critical priority.  
 
‘Recognising skills and experience in addition to qualifications and training pathways for registration sounds promising.
 
‘However, we would need to see a lot more detail, and this would need to be approached very carefully to make sure we get this right to ensure patient safety.’
 
In its response to the release of the final Kruk Review, healthcare regulator AHPRA said ‘significant reform’ has already taken place, noting a 92% increase in new overseas health practitioners registrations in Australia across 2022–23.
 
It also said changes in the registration process have already reduced average assessment times for international applications from 29 days to 10.
 
Ms Kruk was appointed to carry out the work in December last year after National Cabinet agreed to a review to identify ways of simplifying processes and ease healthcare worker skills shortages.
 
The report suggests that putting in place the recommendations and cutting regulatory red tape could benefit the Australian economy by up to $850 million each year.
 
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