01 Sep 2022
The Medical Board and Ahpra have accepted all 16 recommendations to improve patient safety in the cosmetic surgery industry.
Ahpra CEO Mr Fletcher thanked the independent reviewer and expert panel for the comprehensive review and pledged to act immediately, in partnership with the Medical Board of Australia.
‘I am appalled by the tragic stories of patients who were harmed by doctors taking advantage of them – the situation is totally unacceptable and must change. I respect the courage of people harmed by cosmetic surgery who shared their story with the Reviewer,’ Mr Fletcher said.
‘We want everyone who chooses to have cosmetic surgery to be better informed and protected. We want the doctors who undertake cosmetic surgery to be trained to a safe standard. We want the public to feel confident they are going to be well looked after and, if things go wrong, that they will be supported and that their concerns will be acted on,’ he said.
‘We will use our legal powers in full to better protect consumers who choose cosmetic surgery. Registered practitioners in the industry can expect a relentless focus.’
Backed by a $4.5 million investment for extra resources, Ahpra will establish a Cosmetic Surgery Enforcement Unit to work with the Medical Board to:
1. Set clear standards: We want to make it easier for consumers to know who is trained and qualified to do cosmetic surgery safely. As the review recommends, we will create an area of practice endorsement in cosmetic surgery. A doctor’s registration on the public register will show if they have met clear standards in cosmetic surgery set by the Australian Medical Council and the Medical Board of Australia. If Ministers change the Law to protect the title ‘Surgeon’, then only doctors with AMC-accredited qualifications could be called Cosmetic Surgeons in future.
2. Crackdown on advertising: Enforce a ban on testimonials that mislead and deceive consumers and trivialise risk, by cracking down on advertising and social media used to promote cosmetic surgery. We will update and enforce advertising restrictions and use new technologies to audit social media, backed by tougher regulatory action.
3. Tackle under-reporting: Not one of the serious matters featured in recent media coverage was reported to Ahpra by a medical practitioner before it was broadcast, even though many doctors and nurses provided patients with much needed follow up care. Silence allows poor practice to go unchecked and this harms patients. No doctor wants that. We will encourage reporting of patient harm in the cosmetic industry so we can act more quickly to keep patients safe.
We will write to every doctor in Australia so they know what to report and when, and why it’s the right thing to do. Patients will be safer when doctors, nurses and other health practitioners understand their professional responsibility to report unsafe practice.
4. Strengthen patients’ voice: We will target the misuse of non-disclosure agreements (NDAs) to gag consumers in the cosmetic industry. We will launch a campaign to remind consumers that honest disclosure to regulators is legal and their right when things go seriously wrong.
We will also set up a confidential hotline for cosmetic complaints, to make it safe for people who are currently too scared to report harm.
5. Reinforce and strengthen existing guidelines: The Medical Board will strengthen its guidance for medical practitioners performing cosmetic procedures and surgery. We will be stepping up scrutiny and enforcement of the requirements in the Board’s code of conduct and other guidance for medical practitioners who work in the cosmetic industry. We will require practitioners to inform their cosmetic surgery patients of their registration type as part of the informed consent processes. This will ensure patients are aware if their doctor does not hold specialist registration.
6. Changing the way we deal with complaints: We will change how cosmetic surgery complaints are handled in a bid to remove dangerous doctors more quickly. We will centralise experience and establish a national team of regulatory experts to investigate complaints and make decisions about cosmetic complaints. National decision making will be led by the Chair of the Medical Board, Dr Anne Tonkin, supported by an expert investigative team of Ahpra staff, backed by co-opted external regulatory expertise in forensic investigation and social media scrutiny.
7. Working with others: We will work with state and territory health authorities to close current loopholes and address inconsistencies in areas such as facilities licensing and drugs and poisons rules, which are outside our authority and control. These problems are outside National Scheme or practitioner regulation powers and remit and are contributing to patient harm. We look forward to action from jurisdictions to address these issues.
Governance and oversight of this work will be sharpened by a Cosmetic Surgery Oversight Group. This Group will report publicly on progress and assure the community, governments and professional stakeholders that we are doing what we have committed to do, as quickly as possible.
The Oversight Group will be established by Ms Gill Callister PSM who is Chair of the Ahpra Board and will include an independent member who is a recognised champion and expert in consumer protection.
Medical Board Chair, Dr Anne Tonkin, said it was clear that stronger action was needed now and committed the Board to action.
‘A number of practitioners in the cosmetic surgery industry have forfeited the trust of the community and the respect of the medical profession,’ Dr Tonkin said.
‘An area of practice endorsement will set standards and make cosmetic surgery training and qualifications clearer. It will empower consumer choice, by identifying who is trained and qualified, and who is not,’ Dr Tonkin said.
She warned that setting the standard would be hotly contested.
‘There are fiercely different opinions about what qualifications guarantee safe care. Patient safety will be our core focus as we consult with our stakeholders and develop the endorsement,’ Dr Tonkin said.
The cosmetic surgery area of practice endorsement will complement any action by Health Ministers to restrict the use of the title ‘surgeon’.
In November 2021, the Medical Board and Ahpra commissioned an external review of patient safety issues in the cosmetic surgery industry, including how to strengthen regulation of practitioners in the industry.
The independent review was led by Mr Andrew Brown, former Queensland Health Ombudsman, who has 30 years’ experience primarily in legal services, regulatory oversight and complaints management, and an expert panel:
A public consultation from 4 March - 14 April 2022 generated 595 public survey responses and 249 submissions, published at the link below.
The Medical Board of Australia has taken urgent action against all practitioners mentioned in recent media coverage.
The Medical Council of NSW has also restricted Adam Najem’s registration, limiting his ability to perform cosmetic surgery.
In response to calls for Ahpra and the Medical Board of Australia to ban all cosmetic surgery we clarify we do not have the legal powers required to ban cosmetic surgery either temporarily or permanently. There are only three areas of legally restricted practices in our legislation, they are restricted Dental acts, optical appliance prescribing and spinal manipulation, and any addition to these can only be achieved through amending the legislation.