Misconduct management must be ‘strong and robust’: RACGP

The RACGP has called for better protection for patients and healthcare practitioners against sexual misconduct in the workplace, as part of proposed reforms to national regulations.
 
‘It is important to strike the right balance between patient and community protection, and natural and procedural justice for health professionals,’ the college concluded in a new submission.
 
Last year, the nation’s health ministers announced a plan to ensure the ‘management of professional misconduct by health practitioners relating to sexual misconduct and sexual boundary violations would better meet community expectations’.
 
Under that plan, they are investigating whether greater transparency is needed when it comes to a practitioners’ regulatory history.
 
Additionally, they are looking to introduce nationally consistent requirements for practitioners who seek re-registration following cancellation or disqualification, as well as stronger protections for those who make a complaint.
 
The proposal applies to both patients making complaints against healthcare professionals, and professionals making complaints against colleagues.
 
It comes after 15 new reforms were introduced in May, including allowing AHPRA to warn the public about serious risks posed by individuals who are the subject of investigations or disciplinary proceedings.
 
RACGP President Dr Nicole Higgins told newsGP ‘strong and robust processes’ need to be in place when dealing with sexual abuse and misconduct.
 
‘We need to shine a light on the experience of being the victim of sexual misconduct or abuse, to have a discussion around what those boundaries are, what is expected, and what is not acceptable,’ she said.
 
‘GPs as a profession have very low levels of reporting, but because of the sheer number of GPs in Australia, the volume is higher.
 
‘It is a very small minority of doctors who don’t do the right thing, but we need to maintain the confidence of the public and our trainees, and to educate doctors around what is acceptable and what is unacceptable behaviour.’
 
Last year, 5615 notifications were lodged with AHPRA about 4494 medical practitioners, 153 were for boundary violation and 103 for behaviour.
 
In its submission, the RACGP said patients must have the opportunity to make an informed choice about which health professionals they consult.
 
It said publishing and retaining a practitioner’s regulatory history would ensure they are unable to practise if they have been de-registered.
 
However, it raised concerns about the timeframe of this public reporting.
 
‘Despite our members’ support for accountability and transparency, they have expressed concern about retaining information on the public register permanently,’ the submission said.
 
‘It may be appropriate to publish information for a set period and then remove it from the register once it expires.
 
‘We do not support publishing tribunal outcomes where allegations against the practitioner have been disproved.’
 
The RACGP said it also supported allowing practitioners to request information be removed from the public register where there is a risk to their safety or their family.
 
It also called for a nationally consistent requirement for practitioners to seek a reinstatement order from a tribunal before applying for re-registration, as well as education and support for overseas trained doctors who come from cultures vastly different to Australia’s.
 
However, the RACGP said members do not support non-disclosure agreements (NDAs) in the context of a sexual boundary violation or sexual misconduct.
 
‘If an NDA is made however, the affected person should be informed that they can still make a notification to AHPRA or another regulatory body,’ it said.
 
‘Rather than making it an offence not to inform an affected person of their right to make a notification, it would be simpler to make NDA clauses void if notification advice is not given.’
 
The submission likewise references ‘long-standing concerns’ around the management of vexatious notifications, where there is a genuine attempt by a patient or another person, including a colleague, to cause harm to the practitioner.
 
‘The RACGP has previously recommended an overhaul of the notifications process with the intention of easing pressure on AHPRA and the National Boards,’ the submission said.
 
‘A revised process can ensure that complaints are directed appropriately for vetting and assessment, freeing up resources for AHPRA to appropriately manage legitimate notifications.’
 
The college stressed the need for more robust processes to deal with sexual abuse and misconduct committed against doctors themselves by colleagues and supervisors.
 
Research has revealed around one third of all doctors in training have experienced sexual harassment in the workplace, and it is females who are most at risk.
 
Dr Higgins said it is the topic often discussed among female GPs and can no longer be swept under the carpet.
 
‘I know that, especially as a female GP who has lived experience,’ she said.
 
‘It can be very triggering and there’s a lot of vicarious traumas as we deal with it, and also the media around these issues.
 
‘We must define clear boundaries, because everyone deserves to feel safe, to be able to write concerns or to make notifications, whilst at the same time we also need to ensure that proper processes are undertaken.’
 
Submissions to the inquiry are now being considered by health ministries, with a decision set to be handed down by the middle of this year.
 
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female GPs sexual harassment workplace safety