Blueprint to improve public safety in health regulation

14 Feb 2023

Australia’s health practitioner regulator has outlined a blueprint to better protect patients from sexual misconduct in healthcare, as well as a range of broader reforms to keep patients safe.

Some things Ahpra can do quickly, others will require legislative change. The reforms aim to better protect patients from sexual misconduct in healthcare, raise the bar for patient safety, increase transparency and increase support for victims.

`Sexual exploitation of patients is a gross abuse of trust and can lead to long lasting and profound damage. Health practitioners are in positions of power and responsibility and patients are vulnerable,’ Ahpra CEO Martin Fletcher said.

‘The community rightly expects that only practitioners who are fit to practice will be registered and that regulators will take prompt action to protect patients from sexual misconduct by health practitioners.’

‘We have learnt from history and made many changes to better protect patients from sexual misconduct over the past five years, but there is always scope to improve and do more,’ Mr Fletcher said.

To improve it’s handling of sexual boundary matters, Ahpra and National Boards will:

• Commence a public review of the Criminal History registration standard which applies to all registered health practitioners. This review will include looking at how the standard is applied to sexual misconduct offences. 
• Expand our support and information service for victims and witnesses of sexual misconduct, to support them through the regulatory and Tribunal process. The pilot we’ve trialled has been successful.
• Commission research on the outcomes of sexual misconduct matters, looking at whether patients are being protected and what might need to change.  

Ahpra has also presented a wider blueprint for reform to all states and territories to provide a more transparent regulatory system for patients and the public.

A number of these measures require National Law amendments and cross-jurisdiction support, including:

• Ensure the needs of First Nations People are prioritised: Establish new shared governance arrangements with Aboriginal and Torres Strait Islander peak bodies via the National Health Leadership Forum to oversee implementation of the culturally safe notifications program and the broader health strategy towards eliminating racism from health care.
• Strengthen the hand of patients and the public: Increase the role of community members in decision making committees about practitioner misconduct. 
• Greater tribunal transparency: Seek amendments to the National Law requiring tribunals to decide – in an open hearing – if practitioners who have had their registration cancelled can apply for re-registration.
• Improved standards for those harmed by practitioners: Introduce a Charter of Rights for those who have experienced professional misconduct by health practitioners. This could set out the principles to ensure victims and witnesses are acknowledged, respected and provided with necessary support and information through regulatory and tribunal processes and wider use of victim impact statements. 
• More information on the national register: We are keen to publish more information on the national register about practitioners with a history of professional misconduct in sexual boundaries cases. Any change needs Ministerial support. We already publish links to published tribunal decisions and want to extend this.

We have also asked ministers to consider options to streamline the system of health practitioner regulation in Australia – especially in complaints management - so there is less duplication. We need more consistency in approach and decision making and it has to be easier for patients to know where to go.

‘Keeping the public safe is always our focus. We look forward to doing our part and working with governments and other regulators to get the job done,’ Mr Fletcher said.

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