COAG blows chance for genuine NRAS reform
BY AMA PRESIDENT DR TONY BARTONE
The AMA recently lodged its submission to the COAG Health Council on the Regulation of Australia’s health professions: Keeping the National Law up to date and fit for purpose.
The Council is considering potential reforms to the Health Practitioner Regulation National Law (the National Law), which provides the legislative base for the National Registration and Accreditation Scheme (NRAS) for doctors.
Our submission spells out how the AMA considers the COAG Health Council has blown a genuine opportunity to properly evaluate the effectiveness of the National Law.
The COAG consultation document provided to stakeholders did not allow proper analysis of the effectiveness of the scheme.
In the absence of data or any analysis, the consultation paper simply offered a grab-bag of poorly thought-out ideas and thoughts. It lacked intellectual rigour.
The AMA’s major concerns include:
Chairing of National Boards
- The Chair of the Medical Board is a very influential and challenging position, and a non‑medical Chair is simply not equipped or appropriate in this position.
- In the AMA submission to the implementation project for the National Scheme, the AMA first requested that this proposal not proceed. It is frustrating that we have been providing the same advice on this issue, yet it keeps coming back.
Improving the notification and assessment process
- The AMA has supported increased transparency and efficiency throughout the notifications processes since the NRAS was established. Responding to demands for documentation is time consuming and can be stressful when the practitioner is not confident that they are appropriately satisfying the demand.
- There are a number of proposals in the consultation document that would make the current system more efficient and workable. The AMA supports these changes.
Right of appeal of a caution
- The AMA has previously called on the Australian Health Practitioner Regulation Agency (AHPRA) to add a provision for a practitioner to seek independent review of a decision by the Medical Board to issue a caution, and supports this proposal.
- A caution can have a significant negative detrimental effect on a practitioner’s career; and the civil, criminal, and administrative legal systems in Australia generally provide avenues for appeal for decisions that have serious economic or personal consequences on individuals.
Reporting of professional negligence settlements and judgements
- The AMA strongly opposes this proposal and supports the status quo. The AMA believes that the proposed amendments are fraught and have the potential to make significant detrimental changes to the medical insurance landscape.
Production of documents and the privilege against self-incrimination
- The AMA cannot find reasons that AHPRA and the National Boards want to remove this basic common law right and/or create an alternative regime for admissibility of evidence. The AMA does not support this proposal and will strongly contest its development and implementation.
Public statements and warnings
- The AMA does not support the Medical Board or AHPRA being able to issue a public warning even before a tribunal has completed its actions. To do so would imply guilt, and is likely to ruin a practitioner’s reputation.
- A public warning is a severe and non-retractable step and should never be considered before a health practitioner has been shown to have breached a code of conduct or been convicted of a relevant offence.
Published: 15 Nov 2018