In our April Bulletin we foreshadowed that in the coming months there will be considerable Medical Board / Ahpra advocacy work. What is happening will be a major influence on what the Medical Board of 2025 looks like, particularly how it deals with complaints against doctors.
What we have achieved
MIGA works hard for sensible, practical and fair regulation of the healthcare profession. It has worked closely with the Medical Board / Ahpra, governments and professional bodies across a broad scope of issues and contexts.
It has been pleasing to see some important ‘wins’ over the past few years. These include successfully resisting what might have been detrimental changes to professional regulation, a framework for dealing with vexatious complaints, treating practitioner mandatory reporting changes, due recognition of the pressures of the COVID-19 pandemic, an evolved Good Medical Practice Code, a recalibrated approach to regulating off-label prescribing and emerging medicine, and a balanced Professional Performance Framework process. We have also welcomed meaningful and more frequent engagement with the Medical Board / Ahpra across a broad range of emerging and recurring issues.
What we’re looking at now
How the Medical Board / Ahpra operate is being looked at from ‘inside’ and ‘outside’.
A ‘fit for purpose’ review of the Health Practitioner Regulation National Law has been underway for the past couple of years. Governments have decided on the changes to be made, and MIGA’s work on how this will look in practice continues.
Separately the Federal Senate is inquiring into the Medical Board / Ahpra, following a similar review 4 years ago which MIGA was extensively involved in.
Key issues we have raised include:
Role of ‘public confidence’ in dealing with complaints
- The community needs to be confident in those treating them, but MIGA believes the proposed introduction of the concept of ‘public confidence’ as a key consideration in managing complaints is vague and uncertain and the wrong way to do this
- Instead we are advocating for ‘integrity of the profession’ to be a key consideration, referable to widely accepted professional ethics
New mandatory reporting obligations for all ‘charges’ for breaching scheduled medicine requirements
- This risks unnecessary notification for comparatively minor issues, and could significantly increase matters referred to the Medical Board / Ahpra where doctors are dealing with regimes like electronic prescribing and real-time prescription monitoring
- MIGA believes the better approach is to allow medication regulators to inform the Medical Board / Ahpra of serious risks of harm
Broad scope to notify former employers, hospitals and other healthcare providers of any risk of harm
- This could lead to more, longer and broader complaint investigations across a range of matters and impose uncertain responsibilities on those receiving the notification, ranging from a small GP practice to a large tertiary hospital
- MIGA considers the better approach is to limit notifications of places where a practitioner formerly worked to situations where there is a serious and continuing risk to past patients.
Fast forward to 2025…
With a longer-term lens, MIGA sees the opportunity to deal with two key challenges for the Medical Board / Ahpra, namely:
Year on year increases in complaint numbers, with no indication of decreasing standards of care
- Ahpra annual reports over the last 5 years reveal complaints against doctors have almost doubled, but only 20 to 30% over that time have raised any issues of patient safety or fitness to practice needing Board action
- This means much time is being spent on complaints which don’t require the Board’s input, leaving the spectre of regulatory action hanging over a doctor unresolved for some time
- MIGA seeks:
– Better community awareness of where to appropriately raise concerns
– Board / Ahpra having discretion in appropriate matters to ask a patient to attempt to resolve their concern with a healthcare provider directly before their complaint is considered
– Greater scope for earlier referral of mere ‘dissatisfaction’ to State / Territory health complaint bodies to focus on explanations and dispute resolution, not regulatory action.
Improving recognition of and response to systemic issues underpinning many complaints
- Management of complaints tends to focus on the individual – this is often the symptom, not the true cause, of complaints
- MIGA seeks better scope for the Board / Ahpra to examine broader systemic issues, covering issues such as training, staffing levels, fatigue, resourcing and bullying / harassment
- This offers the chance of helping to improve workplace conditions and culture in hospitals and other workplaces, and ensure continuing high standards of healthcare.
These are not issues which can be dealt with overnight. A Medical Board in 2025 that can deal with the complaints it needs to, and look at what is really leading to complaints, is what MIGA is working hard to achieve.
Information in this Bulletin does not constitute legal or professional advice. Call us if you need advice on any of the issues covered in this article.