December 2013 Newsletter

Invitation to attend ASADA December Committee meeting

ASADA's next teleconference committee meeting is on the 17th December 5pm Sydney time. All members are invited to attend. Please email for the teleconference login details and topics that you'd like to address or discuss

 

ASADA's potential constituency

The charts below are compiled from data released by AHPRA: 2012 - 2013.

If we take 60 as the age where doctors are likely starting to be considering stepping back from active practice ASADA's potential membership is just under 20% (18,000*) of the medical profession's 95,600 registered members. *This doesn't include those that are unregistered as they are effectively invisible to AHPRA



Location and Type of Registration


Click for enlarged image

Getting to know AHPRA: Australian Health Practitioner Regulation Agency

AHPRA's operations are governed by the Health Practitioner Regulation National Law Act 2009, as in force in each state and territory. The National Law came into effect on 1 July 2010, except in Western Australia where it came into effect on 18 October 2010. This law means that for the first time in Australia, 14 health professions are regulated by nationally consistent legislation under the National Registration and Accreditation Scheme.

AHPRA supports the 14 National Health Practitioner Boards that are responsible for regulating health practitioners. The primary role of the Boards is to protect the public and set standards and policies that all registered health practitioners must meet.

The Agency Management Committee oversees the work of AHPRA. The Chair is Mr Peter Allen. The Chief Executive Officer is Mr Martin Fletcher.

What AHPRA does
AHPRA supports the National Health Practitioner Boards in implementing the National Registration and Accreditation Scheme.

The National Registration and Accreditation Scheme Strategy 2011-2014 sets out AHPRAÕ s vision, mission and strategic priorities. This statement has been developed jointly by the National Boards and AHPRA.

  • supports the National Boards in their primary role of protecting the public
  • manages the registration processes for health practitioners and students around Australia
  • has offices in each state and territory where the public can make notifications about registered health practitioners or students
  • on behalf of the Boards, manages investigations into the professional conduct, performance or health of registered health practitioners, except in NSW where this is undertaken by the Health Professional Councils Authority and the Health Care Complaints Commission
  • on behalf of the National Boards, publishes national registers of practitioners so important information about the registration of individual health practitioners is available to the public
  • works with the health complaints entity in each state and territory to make sure the appropriate organisation investigates community concerns about individual registered health practitioners
  • supports the Boards in the development of registration standards, codes and guidelines
  • provides advice to the Australian Health Workforce Ministerial Council about the administration of the National Registration and Accreditation Scheme.

In the National Scheme, a complaint about a registered health practitioner is called a ‘notification’. They are called notifications because AHPRA is ‘notified’ about concerns or complaints, which AHPRA manages on behalf of the National Boards.

Anyone, or any organisation, can make a notification to AHPRA, which receives it on behalf of a National Board. The person who has raised the concerns is called ‘the notifier’. Typically, notifications are made by patients or their families, other health practitioners, employers or representatives of statutory bodies. Most notifications are made by individuals with concerns about a registered health practitioner’s health, conduct or  performance.

The National Law provides protection from civil, criminal and administrative liability for people who make a notification in good faith.

Registered health practitioners, employers and education providers have mandatory reporting obligations imposed by the National Law.

  • Registered health practitioners and employers have a legal obligation to make a mandatory notification if they have formed a reasonable belief that a health practitioner has behaved in a way that constitutes notifiable conduct in relation to the practice of their profession.  Notifiable conduct by registered health practitioners is defined as: practising while intoxicated by alcohol or drugs
  • sexual misconduct in the practice of the profession
  • placing the public at risk of substantial harm because of an impairment (health issue) or
  • placing the public at risk because of a significant departure from accepted professional standards.

How many notifications were received?
There were 4,670 notifications received about Medical health practitioners between 1  July 2012 and 30 June 2013 with 1864 conduct, 230 health, 2614 performance related.

Medical Registrants involved in mandatory notifications = 277. Most cases (56%) were closed after the assessment was completed. The remaining cases were closed after an investigation (24%) or a health or performance assessment (15%). A small number (5%) were closed after a panel or tribunal hearing.

Reasons for Notifications:

National Scheme & NSW
National Scheme & NSW


Notifications were made by:

National Scheme & NSW
National Scheme & NSW

National Law notifications closed in 2012/13
  3,456 closed following assessment
  464 closed following investigation
  293 closed following health performance assessment
  74 closed following a panel hearing
  6 closed following a Tribunal hearing
  (total closed = 4,323)

Notifications Outcomes at Closure (ex-NSW)

How much do Australians spend on AHPRA?
AHPRA's Income:
Total income was $165.8 million in 2012-13

Income from transactions
Registrant fee income $152,865m
Interest $6,466m
Other income $6,329m

What AHPRA spends
Staffing costs $76,619 million
Board sitting fees and direct board costs $15,735,000
Legal costs $13,582,000
Accreditation $6,988,000 
Staffing costs $76,619,000 
Travel and accommodation $1,805,000 
Systems and communications $5,658,000 
Property expenses $7,823,000
Strategic and project consultant costs $1,785,000 
Depreciation and amortisation $2,068,000 
Administration expenses $6,869,000
Total expenses from transactions $138,932,000

Medical Board of Australia $12,846,000

Please note that there is no currently data available to the public that separates the amounts that AHPRA recieves or spends per health care sector that I could find at the time of publication.

Remuneration of Chief Executive Officer and National Directors
2013 Income:
$210,000 - $219,999  1
$230,000 - $239,999  1
$250,000 - $259,999  1
$270,000 - $279,999  1
$360,000 - $369,999  1
Total Numbers 5
Total Amount $1,342,950

From the above I conclude that AHPRA has done an excellent job of registering Australia's 95,600 medical practitioners. However in the light of the outcomes for AHPRA's "oversight" where 4,760 notifications resulted in 4,323 being closed without action being taken suggests that Australia may NOT be getting value for money spent.

You can read more about AHPRA by following this link: http://www.ahpra.gov.au/Legislation-and-Publications/Legislation.aspx

A Doctors Duty of Care

With all of the publicity surrounding:  "The Medical Board of Australia vs. Dr Leila Maria Dekker" I have been actively seeking legal opinions as to the "legal" position of a non registered ex-medical practitioner or a medical practitioner with non-practising registration is if they were placed in similar circumstances.

  • ASADA's National Co-Ordinator Stephen Milgate has written a briefing paper "The Medical Board of Australia vs. Dr Leila Maria Dekker" that is available for download from the ASADA website.
     
  • "A brief primer on Good Samaritan law for health care professionals" is available here. This paper discusses the foundations of the Good Samaritan doctrine and the implications of the legislative changes for health professionals.
     
  • Medical practitioners and the duty to rescue
    There is a need to clarify the law relating to the obligation imposed on medical practitioners to render assistance to persons who are injured or at risk of injury. Although a legal duty has been found to exist, the relevant law is in need of clarification in a number of areas especially in relation to determining who actually owes a duty to assist, the precise nature of the duty of care owed, and what steps a medical practitioner must take to effectively discharge their duty to assist. Click to download.

None of the above provides me with a feeling of certainty that I, as a non-registered medical doctor, am safe by rendering or not rendering assistance.  Indeed I feel that I am caught between a rock and a hard place.

I note that The Administrative Tribunal of WA said Dr Dekker’s actions could “reasonably be regarded as improper by medical practitioners of good repute and competency”, and suggested that “saving human life and healing sick and injured people is a core purpose and ethic of the medical profession”.

If saving human life and healing sick and injured people is a core purpose and ethic of the medical profession how is it possible that AHPRA has been allowed to deny many ASADA members this core function?

What did ASADA members who likely have embraced this ethos for 40+ years do to warrant such cruelty?

Perhaps the advent of the Queensland Health Ombudsman office will provide an avenue for ASADA to sort this out? Download the Health Ombudsman Bill 2013

I look forward to 2014 and hope you all have a great festive season.

Simon