The Senate Community Affairs References Committee Complaints mechanism administered under the Health Practitioner Regulation National Law May 2017  Commonwealth of Australia 2017 ISBN 978-1-76010-571-6 Secretariat Ms Jeanette Radcliffe (Committee Secretary) Ms Toni Matulick (Committee Secretary) Ms Sophie Dunstone (Committee Secretary) Mr Michael Kirby (Senior Research Officer) Mr Michael Finch (Research Officer) Ms Carol Stewart (Administrative Officer) PO Box 6100 Parliament House Canberra ACT 2600 Phone: 02 6277 3515 Fax: 02 6277 5829 E-mail: [email protected] Internet: www.aph.gov.au/senate_ca This document was produced by the Senate Community Affairs Committee Secretariat and printed by the Senate Printing Unit, Parliament House, Canberra. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia License. The details of this licence are available on the Creative Commons website: http://creativecommons.org/licenses/by-nc-nd/3.0/au/ ii MEMBERSHIP OF THE COMMITTEE th 45 Parliament Members Senator Rachel Siewert, Chair Western Australia, AG Senator Jonathon Duniam, Deputy Chair Tasmania, LP Senator Sam Dastyari New South Wales, ALP Senator Louise Pratt Western Australia, ALP Senator Linda Reynolds Western Australia, LP Senator Murray Watt Queensland, ALP Participating members for this inquiry Senator Richard Di Natale Victoria, AG Senator Stirling Griff South Australia, NXT Senator Peter Whish-Wilson Tasmania, AG Senator Nick Xenophon South Australia, NXT iii iv TABLE OF CONTENTS Membership of the Committee ........................................................................ iii Abbreviations ....................................................................................................vii List of Recommendations .................................................................................. ix Chapter 1 Introduction .............................................................................................................. 1 Genesis and focus of the inquiry ............................................................................ 1 Overview of the scheme ......................................................................................... 2 Overview of the complaints process ...................................................................... 5 Previous reviews ..................................................................................................... 6 Responses ............................................................................................................... 8 Conduct of the inquiry ............................................................................................ 9 Chapter 2 Lodgement and assessment of complaints ............................................................ 11 Introduction .......................................................................................................... 11 Knowing where to lodge a complaint ................................................................... 11 Vexatious complaints ........................................................................................... 13 Chapter 3 Investigations and national board decisions ........................................................ 21 Confidence in the decision making process ......................................................... 21 Decisions of the national boards........................................................................... 28 Chapter 4 AHPRA's administration of the complaints mechanism .................................... 35 National board guidelines and policies ................................................................ 35 Timeliness ............................................................................................................. 38 Information sharing .............................................................................................. 41 Appeals ................................................................................................................. 42 Chapter 5 Conclusions and recommendations....................................................................... 45 Notifier engagement ............................................................................................. 45 Vexatious notifications ......................................................................................... 46 Clinical peer advice .............................................................................................. 48 Using the process to support practitioners to manage their own risks ................. 50 Guidelines and policies ......................................................................................... 51 Appeals ................................................................................................................. 52 Timeliness ............................................................................................................. 52 Conclusion ............................................................................................................ 53 Chapter 6 Matter of parliamentary privilege: Dr Gary Fettke ........................................... 55 Appendix 1 Submissions and additional information received by the Committee ............... 59 Appendix 2 Public hearings ........................................................................................................ 67 vi ABBREVIATIONS ADA Australian Dental Association AFCC Association of Family and Conciliation Courts AHMAC Australian Health Ministers' Advisory Council AHPRA Australian Health Practitioner Regulation Agency CAA Chiropractors' Association of Australia COAG Council of Australian Governments MBA Medical Board of Australia MIGA Medical Insurance Group Australia National Law Health Practitioner Regulation National Law NHPOPC National Health Practitioner Ombudsman and Privacy Commissioner OHO Office of the Health Ombudsman RACGP Royal Australian College of General Practitioners TBMBA Tasmanian Board of the Medical Board of Australia viii LIST OF RECOMMENDATIONS Recommendation 1 5.14 The committee recommends that AHPRA review and amend the way it engages with notifiers throughout the process to ensure that all notifiers are aware of their rights and responsibilities and are informed about the progress and status of the notification. Recommendation 2 5.24 The committee recommends that AHPRA and the national boards develop and publish a framework for identifying and dealing with vexatious complaints. Recommendation 3 5.28 The committee recommends that the COAG Health Council consider whether recourse and compensation processes should be made available to health practitioners subjected to vexatious claims. Recommendation 4 5.34 The committee recommends that AHPRA and the national boards institute mechanisms to ensure appropriate clinical peer advice is obtained at the earliest possible opportunity in the management of a notification. Recommendation 5 5.39 The committee recommends that AHPRA immediately strengthen its conflicts of interest policy for members of boards and that the Chair of the board should make active inquiries of the other decision makers about actual or potential conflicts of interest prior to consideration of a notification. Recommendation 6 5.44 The committee recommends that AHPRA develop a transparent independent method of determining when external advice is obtained and who provides that advice. Recommendation 7 5.48 The committee recommends that AHPRA consider providing greater remuneration to practitioners called upon to provide clinical peer advice. Recommendation 8 5.56 The committee recommends that AHPRA formally induct and educate board members on the way the regulatory powers of the board can be used to achieve results that both manages risk to the public and educates practitioners. Recommendation 9 5.61 The committee recommends that AHPRA conduct additional training with staff to ensure an appropriately broad understanding of the policies it administers and provide staff with ongoing professional development related to the undertaking of investigations. Recommendation 10 5.67 The committee recommends that the COAG Health Council consider amending the National Law to reflect the Psychology Board of Australia's policy on single expert witness psychologists acting in family law proceedings. Recommendation 11 5.71 The committee recommends that the COAG Health Council consider making a caution an appellable decision. Recommendation 12 5.74 The committee recommends that the COAG Health Council consider whether notifiers should be permitted to appeal board decisions to the relevant tribunal. Recommendation 13 5.80 The committee recommends that AHPRA take all necessary steps to improve the timeliness of the complaints process and calls on the Australian Government to consider avenues for ensuring AHPRA has the necessary additional resources to ensure this occurs. Recommendation 14 5.81 The committee recommends that AHPRA institute a practice of providing monthly updates to complainants and medical professionals whom are the subject of complaints. x