‘Little faith’ in vexatious notifications filter

Guidelines put together by AHPRA to identify and deal with vexatious complaints have done little to ease GPs’ concerns about the process, according to the RACGP.
 
In a response to a National Health Practitioner Ombudsman (NHPO) review, the college has queried the impact of AHPRA’s new vexatious notifications framework.
 
The five-page guidelines were released in late 2020 following a Senate inquiry into complaints under the Health Practitioner Regulation National Law. The framework’s creation was one of 14 recommendations put forward.
 
While the change was welcomed at the time, the college submission to the NHPO says the framework has not helped improve a process that has ‘significant consequences’ for those involved.
 
‘GPs have raised a multitude of concerns in relation to the process, and it appears that AHPRA’s vexatious notifications framework has done little to address these,’ the document reads.  
 
‘There is a prevailing sense that the process is unfair, lacks transparency, and can have devastating effects on practitioners who are not at fault.’
 
RACGP President Dr Nicole Higgins also says the process for weeding out vexatious notifications is not working as it should.

‘There is so much damage done when a complaint that should never been made is allowed to linger needlessly,’ she told newsGP. 
 
‘They need to be identified and cast out more swiftly so GPs can get on with their vital clinical work without this incredibly stressful and time-consuming distraction hanging over them.’
 
In a newsGP poll run last November, only 1% of 1705 respondents said they believed the AHPRA processes for dealing with vexatious complaints are working effectively.
 
One of the specific criticisms of the new framework in the college submission is that while it details the process, it does little to set out any action to deter or reduce vexatious complaints.
 
It simply says that if a manager forms a ‘reasonable view’ that the notification ‘appears to be vexatious’, it should present that information to the National Board ‘with appropriate recommendations to close the notification’.
 
‘Our members consider this blatantly unfair – while patients should have an avenue to make complaints, there must be some deterrent to prevent future vexatious notifications being made,’ the submission authors write.
 
Dr Higgins raises the same issue.
 
‘As it stands, there are almost no disincentives for bad actors looking to damage GPs in this way,’ she said.  
 
‘Stronger measures to stop unreasonable and malicious complaints from being made in the first place can’t come quickly enough.’
 
The same Senate inquiry that suggested the framework also recommended the Council of Australian Governments (COAG) Health Council (now known as the Health Ministers’ Meeting) ‘consider whether recourse and compensation processes should be made available to health practitioners subjected to vexatious claims’.
 
However, that suggestion was dismissed in 2018.
 
The definition of vexatious is also raised by the RACGP, with members expressing concerns it is ‘too narrow’.
 
While research commissioned by AHPRA suggests that vexatious complaints account for less than 1% of notifications, many believe the number is likely to be significantly higher.
 
‘[RACGP members] advise that this does not include many frivolous claims that are not classified as vexatious, and a clear and transparent approach is needed for dealing with these,’ the submission reads.
 
‘Concerns have also been raised about the literature review upon which the <1% figure is based, which members have described as limited.
 
‘There is very little published independent evidence regarding the rate of vexatious or frivolous complaints against health practitioners across the world.’
 
The submission states that college members who provided their feedback feel that ‘any complaint that is found meritless by other practitioners should be deemed vexatious’.
 
In the past 12 months, newsGP has covered several controversial complaints made against GPs.
 
In one instance, Adelaide GP Dr Alvin Chua received a notification, which was later dismissed, after he was injured in an alleged assault by the complainant.
 
In another example, NSW GP Dr Simon Holliday was told by the NSW Health Care Complaints Commission to watch the way he spoke publicly, after an anonymous, error-strewn complaint conflated remarks he had made to local media about the vaccine rollout.
 
The complaint was ultimately dismissed, but Dr Holliday believes the system was effectively ‘weaponised’ against him. While acknowledging that the complaint was not made through AHPRA, Dr Holliday believes that process is also open to similar abuse.
 
Dr Holliday says he knows of complaints made against GPs by patients who were refused scripts or certifications for Centrelink, work and disabled parking.
 
According to Dr Holliday, groundless complaints have also been repeatedly made against the same doctor by the same patient, triggering an investigation each time.
 
All complaints should be triaged by practising doctors, he believes – and he also queries whether anonymous complaints should be accepted, another possibility raised in the RACGP submission.
 
‘The quality of a clinician is not defined by whether he/she always leaves the “customer” satisfied,’ Dr Holliday told newsGP.
 
‘The patient is not just a customer and so the customer is not always right.’
 
One of the most serious implications of a vexatious complaint includes the possibility of driving GPs away from the profession, an outcome the RACGP submission warns about.
 
‘Losing a competent GP from the workforce due to poor handling of the notifications process is extremely concerning, particularly given current poor workforce projections in the sector,’ it states.
 
‘In areas of workforce need, such as rural and remote areas, the loss of a GP may leave whole communities without access to medical care.’
 
In its 2021–22 annual report, AHPRA reported that of 5874 closed notifications, 58.2% resulted in no further action, with only 0.8% leading to a practitioner having their registration surrendered, suspended or cancelled.
 
It did not detail the number of vexatious or frivolous complaints.
 
Meanwhile, the most recent NHPO annual report said there were 823 complaints to the Ombudsman about AHPRA, a 42% increase from the previous financial year.
 
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