National registration scheme at 5 years: not what it promised
Kerry J. BreenDepartment of Forensic Medicine, Monash University, 57–83 Kavanagh Street, South Bank, Vic. 3006, Australia. Email: Kerry.Breen@monash.edu
Australian Health Review 40(6) 674-678 https://doi.org/10.1071/AH15187
Submitted: 13 July 2015 Accepted: 10 December 2015 Published: 18 February 2016
Abstract
A national registration scheme for health professionals was introduced in Australia 5 years ago, replacing the long-standing state-based schemes. This review examines whether the scheme has delivered what it promised and makes recommendations for change. The available evidence indicates that the scheme’s design and its implementation were rushed and that the legislation has serious flaws. Two parliamentary inquiries and the experience of registrants confirm that the system is more expensive, remote and bureaucratic than the previous state-based systems. The scheme has delivered benefits only in relation to portability of registration and a single national register. In addition, with two large jurisdictions participating in a ‘co-regulated’ mode, it is not truly a national scheme. To restore the confidence that health professionals need to have in the regulator, it is recommended that all jurisdictions seek to be ‘co-regulated’ and that the Australian Health Practitioners Registration Authority be pared back to providing a central database for national portable registration.
What is known about the topic? Although selected aspects of the national registration scheme have been the subject of comment, a global critique of the strengths and weaknesses of the national registration scheme has not been published previously.
What does this paper add? This critique identifies several legislative flaws in a scheme that has not met the aims set for it and that is not truly national.
What are the implications for practitioners? Recommended changes to the scheme have the potential to increase practitioner confidence in the scheme while reducing costs.
References
[1] Breen KJ. National registration legislative proposals need more work and more time. Med J Aust 2009; 191 464–5.| 19835545PubMed |
[2] Senate Finance and Public Administration References Committee. Inquiry into the administration of health practitioner registration by the Australian Health Practitioner Regulation Agency. 2011. Available at: http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Finance_and_Public_Administration/Completed%20inquiries/2010-13/healthpractitionerregistration/report/index [verified 10 October 2015].
[3] Parliament of Victoria. Social and Legal Issues Committee inquiry into the performance of the Australian health practitioner regulation. 2014. Available at: http://www.parliament.vic.gov.au/images/stories/committees/SCLSI/Leg_ctee/AHPRA/Final_version_AHPRA_report_30314.pdf [verified 10 October 2015].
[4] Council of Australian Governments. The independent review of the national registration and accreditation scheme for health professionals. 2015. Available at: http://www.coaghealthcouncil.gov.au/Publications/Reports/ArtMID/514/ArticleID/68/The-Independent-Review-of-the- National-Registration-and-Accreditation-Scheme-for-health-professionals [verified 10 October 2015].
[5] Council of Australian Governments. Reissued communique: final report of the independent review on the national accreditation scheme for health professionals. 2015. Available at: http://www.coaghealthcouncil.gov.au/Announcements/ArtMID/527/ArticleID/71/Reissued-Communique-Final-Report-of-the-Independent-Review-on-the-National-Accreditation-Scheme-for-health-professionals [verified 10 October 2015].
[6] Productivity Commission. Australia’s health workforce, research report. Canberra; 2005. Available at: http://www.pc.gov.au/inquiries/completed/health-workforce/report [verified 10 October 2015].
[7] Council of Australian Governments. Intergovernmental agreement for a national registration and accreditation scheme for the health profession. 2008. Available at: http://www.ahwo.gov.au/documents/National%20Registration%20and%20Accreditation/NATREG%20-%20Intergovernmental%20Agreement.pdf [verified 10 October 2015].
[8] Australian Health Workforce Ministerial Council. Communique: Ministers consider submissions on legislation on national registration scheme. 2009. Available at: http://www.ahwo.gov.au/documents/National%20Registration%20and%20Accreditation/Communique%20-%20Ministers%20consider%20submissions%20on%20legislation%20on%20national%20registration%20scheme.pdf [verified 10 October 2015].
[9] Practitioner Regulation Subcommittee, Health Workforce Principal Committee, Australian Health Ministers’ Advisory Council. National Registration and Accreditation Scheme for the Health Professions. Consultation paper: proposed arrangements for handling complaints, and dealing with performance, health and conduct matters. Canberra: AHMAC, Oct 2008. Available at: http://www.nhwt.gov.au/documents/National%20Registration%20and%20Accreditation/Call%20for%20submissions%20on%20proposed%20complaints%20arrangements.pdf [verified 13 January 2016].
[10] Bismark MM, Fletcher M, Spittal MJ, Studdert DM. A step towards evidence-based regulation of health practitioners. Aust Health Rev 2015; 39 483–5.
| A step towards evidence-based regulation of health practitioners.Crossref | GoogleScholarGoogle Scholar | 25796534PubMed |
[11] Goiran N, Kay M, Nash L, Haysom G. Mandatory reporting of health professionals: the case for a Western Australian style exemption for all Australian practitioners. J Law Med 2014; 22 209–20.
[12] Medical Board of Australia. FAQ: limited registration (public interest-occasional practice) ‘who needs to be registered’. 2014. Available at: http://www.medicalboard.gov.au/Codes-Guidelines-Policies/FAQ/FAQ-Limited-registration-public-interest-occasional-practice.aspx [verified 10 October 2015].
[13] Hawton K. Suicide in doctors while under fitness to practise investigation. BMJ 2015; 350 h813
| Suicide in doctors while under fitness to practise investigation.Crossref | GoogleScholarGoogle Scholar | 25680977PubMed |
[14] Medical Board of Australia. Health programs for medical practitioners and students. 2014. Available at: http://www.medicalboard.gov.au/News/Newsletters/April-2014.aspx#Programs [verified 10 October 2015].
[15] Medical Board of Australia. AHPRA and Board respect Supreme Court decision. 2015. Available at: http://www.medicalboard.gov.au/News/2015-07-07-media-release.aspx [verified 10 October 2015].
