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Proposed AHPRA changes show ‘worrying disregard’ for practitioner wellbeing
GPs are at risk of becoming scapegoats should planned amendments to national regulatory principles go ahead, an RACGP submission states.
The RACGP has come out strongly against proposed amendments included in AHPRA’s revised Regulatory principles for the National Scheme.
In a submission signed by RACGP President Dr Karen Price, the college has warned the policy direction represents a worrying disregard for the wellbeing of Australia’s health practitioners.
‘The administration of registration and notifications by AHPRA and related entities can have significant consequences for GPs across Australia,’ the submission states.
‘It is an extremely stressful process and can have severe impacts on practitioner reputation and mental health, even in circumstances where the practitioner is found to be not at fault.
‘The proposed amendments serve to depreciate what few protections health practitioners have when undergoing this stressful process.’
The college is particularly concerned about the National Cabinet (formerly Council of Australian Government) Health Council’s policy direction, which states that the need for effective deterrence must ‘outweigh consideration’ for the potential impact any regulatory action has on the affected health practitioner.
‘This directive is reflected in the proposed changes to the principles, for example replacing “minimum regulatory force” with “necessary regulatory response”,’ the submission states.
‘The proposition that taking regulatory action should be aimed to “deter other practitioners from engaging in similar conduct” is concerning.
‘This stance indicates that AHPRA will in effect make a scapegoat of individual practitioners. To make an example of one person goes against the principles of natural justice.’
It goes on to indicate that the college ‘regularly’ receives feedback from GPs who view the actions of AHPRA as being ‘unnecessarily punitive’, and that members believe there is a lack of balance in the system.
‘AHPRA must assess wider health system impacts which contribute to circumstances of substandard care and ensure these are considered when deciding the appropriate response to a notification,’ the statement signed by Dr Price reads.
‘Public protection and confidence in the National Scheme are important. However, practitioners also need to be protected by, and have confidence in, the National Scheme.
‘It is perceived that the current notifications process is more focused on the prosecution of practitioners than on protecting patient safety through remediation of the issues that led to the complaint.
‘There must also be acknowledgement that many healthcare complaints arise from the need for health system reform, such as safe staffing levels.’
It concludes by pointing out the well-known mental health impact the regulatory and notifications process can have on GPs, as well as potential additional impacts on patients and the health system more broadly in terms of time and financial costs associate with ‘defensive medical practice’.
‘The adversarial nature of the notifications process can make practitioners question their clinical judgement, which could result in a range of unintended consequences such as over-use of investigations, tests and specialist referrals,’ the submission states.
‘According to human rights principles, society has a duty of care to ensure that systems and processes do not increase the likelihood of self-harm, regardless of whether an individual under investigation is at fault or not.
‘The number of doctors who attempt or die through suicide while undergoing regulatory investigation must not be disregarded.
‘While patient safety should be the prime motivation of the notifications process, our members emphasise that a lengthy process, particularly in relation to vexatious or trivial complaints, negatively affects medical practitioners’ mental health and wellbeing.
‘The RACGP sees that to put patient safety first, systems that are fair and supportive to practitioners are essential.’
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