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In 2022/23 we are introducing a new model for allocating costs which considers the complexity, volume, and time to manage the regulatory activity for each profession. The new model reflects access to more detailed data and is designed to ensure costs for regulating each profession are appropriately recovered, target equity levels are maintained, and the risk of cross-subsidisation minimised.
The National Registration and Accreditation Scheme operates on a cost-recovery basis with each Board meeting the full costs for the professions they regulate. A fundamental principle is that there should be no cross-subsidisation across professions or jurisdictions. Accordingly, NSW practitioners do not cover the costs of managing notifications in other states and territories, and vice versa. This is because Part 8 (notifications) of the National Law in NSW is undertaken by the Health Professional Councils in NSW working with the NSW Health Care Complaints Commission (HCCC) in a co-regulatory partnership. Neither Boards nor Ahpra manage notifications which arise in NSW.
For practitioners with a principal place of practice in NSW, the registration renewal fee has two components. The first component relates to the registration and accreditation functions which is the same for all practitioners across Australia. This is calculated by Ahpra. The second component relates to the notifications function. This is calculated by the NSW Health Professional Councils Authority and is specific to NSW practitioners.
To the extent that the total of these two components is lower than the national fee, NSW practitioners receive a rebate in the form of a lower fee. If the total is higher than the national fee, practitioners pay a surcharge.
The agreed registration fee is collected as part of the annual registration renewal process administered nationally by Ahpra. The notifications component is remitted to the HPCA, on a monthly basis, for practitioners with a principal place of practice in NSW, plus approximately 28% of practitioners who do not register a principal place of practice.
While NSW practitioners pay an NSW-specific cost for notifications, they pay the same costs for registration and accreditation as other practitioners in their profession across Australia. The 2009 Ministerial policy direction requires Ahpra and the National Boards to assess the registration and accreditation elements of the fee for NSW practitioners so that it is clear that NSW practitioners are not contributing to the cost of notifications management outside NSW.
The registration and accreditation costs include:
The policy direction can be accessed on the Ministerial directives and communiques page.
In 2022/23, with access to better data on the costs for the regulatory activity for each profession the registration and accreditation fee component for NSW has been corrected. This will see an increase in costs for some professions and a decrease in costs for other professions.
The national costs for registration and accreditation for medical practitioners is $343. This is the same for all medical practitioners across Australia and there is no difference in this cost for medical practitioners in NSW.
The policy direction requires us to assess the registration and accreditation element of the fee for NSW practitioners. Our cost allocation work shows that we have been under-recovering the costs of registration and accreditation for medical practitioners with a principal place of practice in NSW. We are not recovering any prior year costs and have no plans to do so. However, we must comply with the policy direction and correct this component of the fee for NSW in 2022/23.
More widely, the Medical Board of Australia is managing the increase in costs of regulation for medical practitioners in other jurisdictions by going into a budget deficit in 2022/23. The Medical Board deficit can’t be used to cover NSW registration and accreditation costs because the policy direction clearly requires the actual cost to form the registration and accreditation component of the fee. This ensures that NSW practitioners are not cross-subsidising the costs of notifications for practitioners in other jurisdictions or vice versa.
The NSW notifications component of the national registration and renewal fee for NSW based medical practitioners will rise by $110 in 2022/23 to $555. This means the total fee for NSW medical practitioners will be $898. It is the first time the NSW complaints component has been adjusted above CPI since 2012. Like Ahpra and the National Boards, the Medical Council of NSW operates on a cost recovery basis and this change is necessary because of a substantial increase in complaints and associated regulatory activity in NSW.
Audited financial statements are published in the Ahpra annual report which is published every November on Ahpra’s website.
Ahpra’s data on registration and accreditation performance can be accessed on the statistics page on Ahpra’s website.