Senate Committee urges limits to AHPRA complaints

Significant changes to how the Australian Health Practitioner Regulation Agency (AHPRA) operates could lie ahead if the advice of a Senate Committee is taken up.
 
Limiting AHPRA complaints to clinical patient safety concerns, as well as dropping mandatory reporting obligations, are among the proposals put forward by the Community Affairs References Committee.
 
Their inquiry into AHPRA’s administration of health practitioner registration and notifications produced 14 recommendations in a report published last week.
 
Among them is a proposal to consider National Law reforms that would refer low-risk notifications to health practices and services, and limit AHPRA notifications only to ‘clinical issues relating to patient safety’.
 
The report also acknowledges the ‘significant amount of stress’ involved in the current notifications process, as well as the challenges posed by vexatious notifications.
 
In particular, the committee said it was ‘deeply concerned and moved by the stories it has heard regarding the devastating impact of a notification on some health practitioners’.
 
RACGP President Clinical Professor Karen Price said the recommendations would make ‘a real difference’ if they are put in place and welcomed a proposal to increase education and awareness.
 
‘We have long been saying that there must be a common-sense approach to regulatory compliance,’ she said.
 
‘GPs shouldn’t be punished and stressed unnecessarily when they’re just doing their best to care for their patients, rather there should be more education and awareness-raising activities to ensure practitioners fully understand the rules.
 
‘I urge swift action to implement these important recommendations and welcome the opportunity to provide advice on implementation from a general practice perspective.
 
‘If implemented appropriately, these changes will make a real difference for GPs and other health practitioners working hard on the frontline to care for patients, and communities.’
 
The RACGP has advocated strongly for reform, with many GPs having either personally experie­­­­­nced, or known a colleague who has experienced, the negative consequences of the current system.
 
The inability of the current notifications process to vet vexatious complaints was a key concern of the college’s submission to the inquiry, as was the mental health impact of such complaints on doctors.
 
Another recommendation, also welcomed by Clinical Professor Price, is to ‘remove the current mandatory reporting requirements and align the approach with the Western Australian model’.
 
‘Doctors have the right to receive confidential treatment like any other professional, without fear of repercussions to their medical registration,’ she said.
 
‘I encourage all GPs to take time to care for themselves. Remember: it’s okay for a doctor not to be okay. So please reach out if you do need help.’
 
Unlike other states and territories, medical practitioners in WA are exempt from mandatory reporting obligations.
 
However, they may choose to make a voluntary notification if it is in the interest of public safety.
 
Elsewhere, under the National Law, registered health practitioners, employers and health education providers are required to make a mandatory notification to AHPRA about a health professional’s conduct if it poses a risk to the public.
 
The report said the committee was ‘alarmed to hear about the detrimental impact’ of mandatory reporting and how it posed a significant barrier to health professionals seeking help and treatment.
 
The committee also noted the broad support for the WA model from peak bodies.
 
Other key recommendations focus on the need to address supervisory failures, regulate other unregulated health workers, including aged care workers, and facilitate restriction of the ‘surgeon’ title as a matter of priority.
 
In response to the inquiry, AHPRA stated it plans to ‘consider the recommendations’ and will contribute as requested to the formal Australian Government response.
 
Recommendations in full:

1. The committee recommends that proposed reforms to the National Law to regulate the use of the title ‘surgeon’ undergo broad consultation and be progressed as a priority by the Ministerial Council. 
2. The committee recommends that AHPRA and the national boards introduce a more flexible re-registration model across professions that would enable health practitioners to more easily re-enter the workforce after a period of absence. 
3. The committee considers there is a substantial case for regulation of currently unregulated professions including social workers, aged care workers and personal care workers and recommends the Ministerial Council consider whether these professions should be included in the National Regulation and Accreditation Scheme.
4. The committee recommends that AHPRA undertakes urgent and immediate action in relation to supervisory failures and ensure that individual cases are not indicative of a systemic failure. 
5. The committee recommends that all supervisors should have a direct point of contact within AHPRA and that this point of contact should be made available prior to any contractual arrangements being made, as well as throughout the entire supervisory period.
6. The committee recommends AHPRA reviews and simplifies its published information about notifications and other complaint pathways. 
7. The committee recommends that AHPRA and the national boards undertake education and awareness activities, explaining notifications and other complaints pathways, with health practices and services.
8. The committee recommends that the Ministerial Council considers reforms to the National Law to enable health practices and services to be referred low risk notifications to be dealt with in the first instance, and that AHPRA and the national boards have discretion to refuse these matters on that ground.
9. The committee recommends that notifications accepted by AHPRA be limited to clinical issues relating to patient safety. 
10. The committee recommends that AHPRA and the national boards consider improving the notifications data it collects and publishes to better understand where protracted timeframes are experienced and the reasons for any delays. 
11. The committee recommends that AHPRA and the national boards undertake an analysis of the cause of protracted notifications timeframes and identify ways to further improve timeliness. Consideration should be given to: 
    • what further decision-making powers of the national boards can be delegated to AHPRA; 
    • the allocation of resources to deal with increasing volumes of notifications; and 
    • establishing timeframes for aspects of the notifications process. 
12. The committee recommends that AHPRA and the national boards develop and publish a strategy for identifying systemic issues and working with stakeholders to proactively address areas of concern. 
13. The committee recommends that the Ministerial Council agrees to remove the current mandatory reporting requirements and align the approach with the Western Australian model. 
14. The committee recommends that AHPRA and the national boards develop and fund a comprehensive strategy for providing tailored support for the notifications process to practitioners in all regulated professions.

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