Australian Health Practitioner Regulation Agency

Australian health agency

Australian Health Practitioner Regulation AgencyAgency overview

Formed| 1 June 2010 (2010-06-01), 18 October 2010 (2010-10-18) for Western Australia[1]
Jurisdiction| Commonwealth of Australia
Agency executives|

* Martin Fletcher[2], CEO
* Chris Robertson, Executive Director, Strategy and Policy
* Kym Ayscough, Executive Director, People and Culture
* Clarence Yap, Chief Information Officer
* Liz Davenport, Chief Financial Officer

Website| www.ahpra.gov.au

The Australian Health Practitioner Regulation Agency (AHPRA), infrequently spelt as the Australian Health Practitioners Regulation Agency,[3] is a statutory authority founded in 2010 which is responsible, in collaboration with the Medical Board of Australia, for registration and accreditation of health professionals as set out in the Australian legislation called the National Registration and Accreditation Scheme.[4][5][6] As of 2018[update], approximately 586,000 health professionals were registered with the AHPRA, containing 98,400 medical practitioners (which includes general practitioners, medical specialists and some hospital workers[5]), and 334,000 nurses and midwives.[4] This rose to 825,720 registered health professionals in 2021.[7]

The AHPRA is intended to facilitate public safety of health practice in Australia, and is used to assess the qualifications of overseas health practitioners.[1] According to the National Registration and Accreditation Scheme, it is required to be registered with the AHPRA to self-identify with one of the "protected titles" set out in the legislation, and it is an offence to do so without registration.[1] The AHPRA maintains a public register of those registered and related qualifications accessible from their website.[8] The AHPRA is responsible for hearing and investigating complaints (which are legally termed "notifications"[6]) of "performance, health and conduct" by those registered.[8] The AHPRA is also responsible for hearing complaints about unregistered professions, which includes "unregistered health care workers who provide a health service", in violation of the National Code of Conduct for health care workers[9] by behaving in an incompetent, exploitative, predatory or illegal manner.[6]

Martin Fletcher has been the chief executive officer of the AHPRA since its inception.[2] According to a 2011 publication, "Australia is [sic] the first country in the world to have a national registration and accreditation scheme regulating health practitioners."[10]

## Regulated professions

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As of 2022[update], the AHPRA regulates 16 medical professions in Australia. 12 of these were enacted under the National Registration and Accreditation Scheme on 1 July 2010, listed exactly as:[1]

* Chiropractors
* Dental practitioners (including dentists, dental hygienists, dental prosthetists, and dental therapists)
* Medical practitioners
* Nurses and midwives
* Optometrists
* Osteopaths
* Pharmacists
* Physiotherapists
* Podiatrists
* Psychologists

In July 2012, this was expanded to include 4 additional professions:[1]

* Aboriginal and Torres Strait Islander health practitioners
* Chinese medicine practitioners (including acupuncturists, Chinese herbal medicine practitioners and Chinese herbal dispensers)
* Medical radiation practitioners (including diagnostic radiographers, radiation therapists and nuclear medicine technologists)
* Occupational therapists

The set of "protected titles" also includes common variations on these profession titles.[1] As of June 2022[update], the following professions are not regulated by, and do not have "protected titles", under the National Registration and Accreditation Scheme:[11]

* Social workers
* Speech pathologists
* Dieticians
* Audiologists
* Sonographers
* Orthotist/ prosthetists
* Perfusionists
* Exercise and sport scientists

As of June 2022[update], although there exists guidelines under the AHPRA for "medical practitioners who perform cosmetic medical and surgical procedures",[12] the term "surgeon" and related terms like "cosmetic surgeon" are not "protected titles".[13] This meant that registered medical practitioners in Australia could these titles even when having different training and qualifications.[14] A public consultation about this began on 1 December 2021 via Engage Victoria, an online platform run by the Victoria government department of health, which closed feedback submissions on 1 April 2022.[13][14]

Each regulated health profession is represented by a national board, of which there are 15,[15][8] along with 21 specialist organisations.[5]

## Registration

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There are four categories of registration conducted through the Medical Board of Australia, depending on training and expertise, including "general", "specialist", "provisional", "limited" and "non-practicing", along with a student registration.[16] Medical graduates applying from New Zealand are treated with the same registration standards as Australians, differing from the international registration process.[17] As of 22 July 2021[update], there are separate fees for both registration and application. Initial registration and application fees for general, specialist and limited registrations is $835 AUD, with some categories of New South Wales registrations receiving rebates.[18]

The registration process includes a criminal history check, where individuals must inform the national board under application jurisdiction if they have been "charged with an offence punishable by 12 months imprisonment or more, or convicted or found guilty of an offence punishable by imprisonment in Australia and/or overseas".[19] There exists a dispute resolution process with the Australian Criminal Intelligence Commission and relevant police departments, if the result of a criminal history check prevents registration under the AHPRA.[20]

## Complaint process

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In the AHPRA, complaints are termed "notifications".[6] The complaints process includes several stages, which may advance a stage, result in disciplinary action, a fast-track process called "immediate action", or the complaint may be dropped.[21] The stages include a receipt of the complaint, preliminary assessment, investigation, panel hearing, and a tribunal hearing, and at any stage of the process the complaint to advance immediately to a tribunal hearing.[21] Unlike the other stages, a tribunal hearing outcome is made to the public, and a tribunal typically consists of "a District Court judge, two medical practitioners and a lay person, specifically appointed to consider the evidence".[22]

According to AHPRA, in 2021 there were 10,147 notifications about 7,858 health practitioners, and 1.6% of those registered were the subject of a complaint.[7][a] According to Sharon Russell, "many medical practitioners will be the subject of an AHPRA complaint at some stage during their career".[22]

Complaints can be made online via the AHPRA website, by mail, telephone or attending an office. There is also a whistleblower policy governed under the Public Interest Disclosure Act 2013 where anonymous complaints can be made for serious misconduct.[23]

## Criticism

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The AHPRA has been subject to criticism, including for medical right to privacy and informed consent of those registered,[24][25][26] and the long amount of time taken to resolve complaints.[27][28][29] There was an investigation in 2014 following complaints to the AHPRA about how complaints are managed, including a lack of transparency over the complaint review process, and delays in investigations, with one case taking 2,368 days to resolve. There have been senate inquiries (see Australian Senate committees) by the Parliament of Australia in 2011, 2017 and 2021 over related issues.[30][31] The 2021 public submission of support from the Royal Australian College of General Practitioners identified the main issues with the AHPRA as being "communication, transparency and timeliness of the complaints mechanism, and the importance of appropriate recognition of the impacts of assessment and investigation on a practitioner’s mental health".[32][33] Over a four-year period, researchers identified 16 suicides and a further four instances of attempted suicide or self-harm among health care workers subject to regulatory notifications.[34]

Submissions for the 2021 senate inquiry were extended to March 2022, with the final senate report being released on 1 April 2022.[35][36] The senate inquiry resulted in 14 recommendations, including improving the complaints process, more flexible re-registration after a period of absence, and the regulation of surgeons, social workers, aged care workers and personal care workers along with adding these professions to the list of "protected titles".[37][38]

## References

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1. ^ It is implied from the source the 1.6% figure refers only to the year 2021.

1. ^ a b c d e f "Australian Health Practitioner Regulation Agency FAQ". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
2. ^ a b "Ahpra Senior Managers". Medical Board of Australia. Retrieved 2022-06-12.
3. ^ "Australian Health Practitioners Regulation Agency". Tasmania legal aid. Retrieved 2022-06-12.
4. ^ a b "Health workforce". Australian Institute of Health and Welfare. Retrieved 2022-06-12.
5. ^ a b c "Medical doctors and specialists in Australia". Department of Health (Australia). Retrieved 2022-06-12.
6. ^ a b c d "National Registration and Accreditation Scheme". Department of Health (Australia). Retrieved 2022-06-12.
7. ^ a b "Ahpra in numbers". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-13.
8. ^ a b c "Ahpra and the Boards". National Health Practitioner Ombudsman and Privacy Commissioner. Retrieved 2022-06-12.
9. ^ "National Code of Conduct for health care workers" (PDF). Holistic Therapists Australia. Retrieved 2022-06-13.
10. ^ Warnock, Jason; Banful, Ebenezer; Foley, Laurie; Gilheany, Mark; Hunter, Anne-Marie; Loughry, Cathy; Matthews, Helen; Russell, Joan; Tinley, Paul (2011-05-20). "The national registration and accreditation scheme". Journal of Foot and Ankle Research. 4 (S1). doi:10.1186/1757-1146-4-s1-i12. ISSN 1757-1146. PMC 3102918. S2CID 27227863.
11. ^ "National Registration and Accreditation Scheme - AASW - Australian Association of Social Workers". www.aasw.asn.au. Retrieved 2022-06-13.
12. ^ "Guidelines for registered medical practitioners who perform cosmetic medical and surgical procedures". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-14.
13. ^ a b "Ahpra welcomes consultation on surgeon title". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-14.
14. ^ a b "Medical practitioners' use of the title surgeon under the National Law". Engage Victoria. Retrieved 2022-06-14.
15. ^ "National Boards". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
16. ^ "Types of Medical Registration". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
17. ^ "Australian and New Zealand medical graduates". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
18. ^ "Fees". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
19. ^ "Criminal history". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
20. ^ "Criminal history checks". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-12.
21. ^ a b "AHPRA Complaints Process". Legal Services Commission South Australia. Retrieved 2022-06-13.
22. ^ a b "AHPRA Complaints Process". MDA National Insurance. Retrieved 2022-06-13.
23. ^ "Public Interest Disclosure (Whistleblower) Policy". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-13.
24. ^ "AHPRA register draws criticism from judge". AusDoc.PLUS. 2014-05-13. Retrieved 2022-06-12.
25. ^ "My letter to AHPRA - Health Practitioners Must Not Be Intimidated". Senator Gerard Rennick. 2021-12-24. Retrieved 2022-06-12.
26. ^ "Work needed to ensure AHPRA system is impartial and follows due process". Australian Medical Association. 2021-06-10. Retrieved 2022-07-10.
27. ^ Robinson, Alice (2022-04-05). "Senate Committee report released in relation to administration of the National Law and AHPRA". Panetta McGrath Lawyers. Retrieved 2022-07-10.
28. ^ McGrath, Gemma (2017-05-14). "Senate Standing Committee on Community affairs report into complaints management. - Panetta McGrath Lawyers Perth". Panetta McGrath Lawyers. Retrieved 2022-06-12.
29. ^ "Is the AHPRA complaints mechanism broken? • The Medical Republic". The Medical Republic. 2017-03-24. Retrieved 2022-06-12.
30. ^ "New Senate inquiry into AHPRA • The Medical Republic". The Medical Republic. 2021-03-26. Retrieved 2022-06-12.
31. ^ Dolan, Carly (2017-06-21). "Health watchdog to implement changes". The Examiner. Retrieved 2022-07-10.
32. ^ "Submission to Senate inquiry - Ahpra and related entities". Royal Australian College of General Practitioners. Retrieved 2022-06-12.
33. ^ "AHPRA labelled a 'faceless bureaucracy' ahead of Senate inquiry • The Medical Republic". The Medical Republic. 2021-06-18. Retrieved 2022-06-12.
34. ^ AMA. "Ahpra data confirms traumatic effect of regulatory process on doctors and need for change". AMA. Retrieved 2024-08-28.
35. ^ "Administration of registration and notifications by the Australian Health Practitioner Regulation Agency and related entities under the Health Practitioner Regulation National Law". Parliament of Australia. Retrieved 2022-06-12.
36. ^ "Senate inquiry 2022". National Health Practitioner Ombudsman and Privacy Commissioner. Retrieved 2022-06-12.
37. ^ Samecki, Anna (5 April 2022). "Senate Committee urges limits to AHPRA complaints". newsGP - The Royal Australian College of General Practitioners. Retrieved 10 July 2022.
38. ^ "List of Recommendations". Parliament of Australia. Retrieved 2022-06-12.

## External links

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* National Code of Conduct for health care workers
* AHPRA Regulatory Guide - June 2022
* AHPRA Regulatory Guide Overview - June 2020
* Health Practitioner Regulation National Law Act 2009, the legislation governing the National Registration and Accreditation Scheme, current to at least 1 August 2018[1]

1. ^ "Legislation". Australian Health Practitioner Regulation Agency. Retrieved 2022-06-13.