RACGP calling for feedback on draft mandatory reporting guidelines

The draft mandatory reporting guidelines, by which the Australian Health Practitioner Regulation Agency (AHPRA) released for public consultation in September, have been controversial among many healthcare advocacy bodies, including the RACGP.
 
Many believe the amendments to the laws, which were debated and passed in Queensland Parliament earlier in 2019, will not remove the barrier to doctors seeking help for mental health issues due to the requirement that treating practitioners report doctor-patients if they believe public safety is at risk.
 
‘The way the legislation’s constructed, the onus of proof is on the treating practitioner to justify why they have not made a mandatory report, rather than why they need to,’ RACGP Queensland Chair Dr Bruce Willet told newsGP last month.
 
‘There’s a reverse onus of proof and the fear, of course, is that it may prevent practitioners from seeking help.’
 
The RACGP does not support the current approach to mandatory reporting and has long called for nationwide adoption of the Western Australia model, which exempts treating practitioners from having to report doctors in their care.
 
However, recognising that the laws stand as they currently do, the college sought to improve the existing situation for the benefit of doctors with its submission on the draft guidelines earlier this year. Its suggested amendments aimed to further limit the circumstances triggering treating practitioners to make a mandatory notification by seeking clarification in the guidelines on when a report is and is not required.
 
Since the RACGP’s submission, the draft guidelines have been revised and restructured to provide better clarity for doctors and their treating practitioners, with many of the recommendations incorporated.
 
As part of these changes, a section explaining the circumstances where a report is not required is now included at the beginning of the guidelines, to provide improved clarity for treating practitioners. Content has also been restructured to make it more concise, accessible and understandable for those using it, including its risk grid charts and flow charts.
 
One of the RACGP’s strongest concerns is regarding the use of ill-defined terminology, which it believes creates the potential for confusion when dealing with sensitive and complex situations of mental health.
 
As such, the RACGP requested plain-English definitions of terms such as ‘harm’, ‘material harm’ and ‘insignificant harm’ to be included in an appendix, and that such terms be applied consistently throughout the document.
 
‘The Queensland legislation talks about “significant risk of harm”, whereas the AHPRA guidelines refer to a “risk of significant harm”,’ Dr Willet said.
 
‘That might sound like a small difference, but the point I made to the Queensland Health Minister is that [it’s just like] when I drive home every day – I am at significant risk of causing harm to people, just by the nature of the action.
 
‘It needs to be a risk of significant harm, and the threshold needs to be reasonably high.’
 
While the RACGP continues to oppose the model of mandatory reporting applied to most states and territories (with the exception of WA), it has said it remains committed to making the current process as clear as possible for health practitioners.
 
The RACGP is now seeking further feedback from all members on other improvements to the guidelines that they would like to see in order to clarify the purpose of the amendments, reduce confusion around when a report is required, and ensure practitioners feel comfortable seeking care without fear of losing their registration.
 
Guidance for member comment is available on the RACGP website, and the closing date for comments is Monday 14 October.

AHPRA GP mental health mandatory reporting submissions