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15 Oct 2025
Ahpra's CEO, Justin Untersteiner, delivered the Langford Oration speech on Tuesday 14 October to the Royal Australasian College of Medical Administrators (RACMA) 2025 annual conference held in Perth.
I’d like to acknowledge the Whadjuk Nyoongar people as the Traditional Owners of the lands we gather on today here in the beautiful city of Perth – or Boorloo. I pay my respects to Elders past and present and extend a very warm welcome to all Aboriginal and Torres Strait Islander people joining us.
I’ll also pay respect to the custodians of my hometown, Melbourne – the Wurundjeri people of the Kulin Nation. I celebrate their continuing connection to culture and give my thanks for the great care they’ve always taken of our country, sea and community.
It’s a pleasure to be joining you all today at this auspicious event. It’s an honour to be invited to share such a momentous occasion with you.
So, I will start by saying congratulations! A Fellowship with the Royal Australasian College of Medical Administrators is evidence of the highest skill and a significant accomplishment.
In a stroke of impeccable timing, I’m also told this week marks exactly 15 years since Western Australia joined the National Registration and Accreditation Scheme (18 October). WA was the last jurisdiction to come on board, making the scheme truly national. Another reason to celebrate.
As the CEO of the Australian Health Practitioner Regulation Agency, I have very clear responsibilities around upholding the standards of the health profession, supporting a sustainable workforce and protecting the safety of the public and registered practitioners.
And so, it’s easy for me to affiliate with RACMA’s vision: A future where world-class healthcare is shaped by the wisdom, experience, expertise and innovation of all involved in the system.
That is a strong aspiration of stewardship. And across an ecosystem as complex and intricate as our health system, it’s this concept of collaboration, joint ownership, accountability and shared vision that’s key to sustainability and success.
If stewardship is the ‘how’ then safety is the ‘why’. And I’m referring to safety in all its forms, for all people accessing and administering healthcare, in any capacity. This is nicely articulated in RACMA’s mission: We build capability for a safer, more effective and equitable health system. For everyone in this room, public safety is, and must remain, our number one priority.
Today, I’ll explore these two themes in more detail: stewardship and safety – the how and the why – what they mean to me as a CEO, what they mean to Ahpra as the regulator of registered health professionals in Australia – and what they might mean to you, as our newest cohort of health leaders.
But first, let me share a bit about myself – and my first six months at Ahpra.
As I mentioned, I live in Melbourne with my wife and our two young kids. I’m a hands-on parent – involved in their sports, their learning, and the things they’re passionate about. My wife and I share the load: school drop-offs and pick-ups, managing sick days, and the juggle of school holidays. It matters to me. I want to be present. I want to help shape who they become.
Outside of work, I love to read, I’m learning to play tennis, and I’m a passionate motorcycle rider.
I share this because it’s easy – especially in leadership – to become completely consumed by the job. And don’t get me wrong, like you, I carry big responsibilities. There are times when the work demands everything from me.
But without deliberately making space for balance – without carving out time for the things that keep us grounded – we risk losing perspective. And when we lose perspective, we burn out. Or worse, we risk burning out those around us.
Balance makes us better. It’s how I stay energised. It makes me a better CEO, and a better person.
If you take one thing from me tonight, let it be this: make time for the things you love outside of work. You’ll be grateful you did.
You may be aware that I am the first new CEO at Ahpra since its inception, over 15 years ago. I’ve joined an organisation that has come a long way in that time and has a lot to be proud of. But it has to be said, we haven’t always met expectations or kept pace with changing developments within our environment.
My appointment was about setting Ahpra on a path of accelerated evolution. And there’s never been a better time.
The healthcare system is being pushed and pulled in new directions, with multiple intersections and influences for consumers, practitioners, and a myriad of businesses who support the provision of services.
We’re seeing:
And we're seeing:
Being a leader is rarely an easy task, even in simpler times. Now we find ourselves needing to operate amidst unprecedented change, complexity and pace. I say 'we' because this is also the environment you will be working in as medical administrators.
It would be easy to become overwhelmed so, as a new CEO, I’ve distilled my focus to three things:
First of all, listening to people – I like to remind my kids they have two ears and one mouth for a reason, and I try and put that into practice myself.
I’ve dedicated a huge amount of my time since I started, getting out and meeting people, having conversations and listening to the experiences and perspectives of others.
‘Listening to understand’ also means respecting the past and appreciating that things were done at a point in time, for a reason. It’s about accepting where we’ve come from and where we are now, in order to learn and move forward.
Secondly, knowing what matters most and what matters now – being strategic about what needs our attention and effort.
With so much feedback coming in, I have to look at where we can have the biggest impact and how we can make space for that. I believe we can do just about anything, but no one can do everything. To over-promise and under-deliver would undermine confidence in Aphra.
And thirdly, demonstrating progress. While we can’t do everything all at once, we must be responsive. Perpetual reviews of Aphra’s performance indicate an appetite for change and resounding support for new ways of regulating the system. We can’t stand still.
As I’m listening – to staff, practitioners, community and consumers, government, education and training providers, Aboriginal Community Controlled Health Organisations – actually anyone with something to say, it’s clear we have work to do, to rebuild trust and confidence in Aphra.
The themes I’m hearing all point back to increased safety in the system. These include:
1. a notification system that better supports patients and practitioners. To do that, it must do four things well:
2. harm prevention – not waiting for harm to be reported but stopping it in the first place. We must be a leader in harm prevention, building fences at the top of dangerous cliffs rather than sending more ambulances to the bottom
3. creating more avenues for community input into the National Scheme and how it’s administered
4. a steadfast commitment to eliminate racism in the health system and embed cultural safety for all Aboriginal and Torres Strait Islander Peoples, and
5. a health workforce that can meet increasing demand, giving Australians access to high quality healthcare, regardless of where they live.
To make progress, these goals must be underpinned by improved stakeholder partnerships and engagement, a stronger focus on the user experience, data access and transparency, and efficient tech-enabled systems and workflows.
And these aren’t just our ideas; they’re being reinforced by extensive consultation on our National Scheme Strategy. So far, we’ve run consultation sessions with thousands of participants, to ensure we focus on what matters most. The new strategy will be released early in the New Year.
It’s not enough to simply identify the shortfalls and opportunities – we must take action and chart a course of relentless improvement. It would be naive of me to think this is the job of one CEO, one Board, or one organisation.
To use a musical analogy, it will take a symphony of experts, across all sections of our complex health ‘orchestra’, playing in concert, to harmonise our health system.
A thriving system is one where there is harmony. We all bring different instruments, there is beauty in variation, but the outcome is cohesive and far more impactful than the sum of its parts.
This is how we bring stewardship to life.
In this arrangement, I think it’s reasonable to say, that regulation often gets a bad rap. Like a mistimed clash of the symbols, if it’s not done right, it can seem jarring and out of kilter.
We feel this when:
I want Ahpra to be the kind of regulator you want to advocate for. One that aligns to your vision for the medical profession and supports you to lead in a field that is innovative, high performing, an exemplar of integrity and in need of your unrelenting commitment.
We know we have a way to go to earn that kind of trust and endorsement, but we are making progress. For example, we’re:
We’re seeing overseas practitioners enter the Australian system via our new expedited pathway for Specialist International Medical Graduates (SIMGs). To date 343 applicants have been registered through the expedited specialist pathway, with around 86 per cent practising in identified areas of workforce shortage (including fast-growing outer metropolitan areas).
We’ve also:
We’ve restructured the organisation, introducing three new Directorates with a stronger focus on health workforce and health regulation as well as regulatory governance.
We also launched a new operating system in March, which – though not without some teething issues – includes a portal for faster, more secure online applications. This is the biggest IT system upgrade Ahpra has made since it began.
We’re taking steps towards, safer, fairer, and more sustainable regulation.
From those examples, in this room this evening, and across the health sector more broadly, we are united in our pursuit of safety.
At its core, that’s protecting people from danger, risk, or injury – physical, psychological or cultural – for all people in all situations, online and in person.
If Ahpra is to be a leader in harm prevention, we must be responsive, responsible and relevant.
This is about really understanding the systems we administer, acting decisively and proportionately, being accountable and transparent, and remaining contemporary.
As you venture into key leadership roles across our healthcare delivery network, we need your help. I am personally calling on you to be part of our health ‘orchestra’ which aims to keep our community safe. I am asking you to:
As a regulator, we are accountable for standards, accreditation and registration. Ahpra must implement the National Law – but we need hold that role in the context of a somewhat tumultuous operating environment and the system as a whole. We can’t be setting arbitrary boundaries around our ability to influence. And neither should you.
Like all good partnerships, stewardship and safety are powerful and worthwhile, each in their own right. But it’s the combination of the two that will realise the biggest impact.
Before I close, I’d like to prompt you to think about why you’ve chosen this path – at times it will feel steep, winding, unstable and overwhelming. What is the impact you want to make? What is the legacy you’ll leave?
Before I had even started at Ahpra, I wrote myself a legacy statement. It’s not a public declaration but a personal commitment to the future – an articulation of what success means to me. It’s certainly ambitious and maybe even a fraction arrogant to think I can achieve it all. But I’m determined to try, and to lead openly and authentically.
So, to realise my legacy, I’m going to need play more than one instrument:
As you step back into the controlled chaos and commotion of your workplaces, think about what you’re bringing with you and how it adds to the symphony.
In the spirit of authenticity, I will admit before I go, that my musical preferences lean more towards heavy metal than an orchestral symphony – but it didn’t seem to fit the bill quite as nicely!
As you embark on this next phase of your careers, keep fine-tuning your instruments and your practice.
I look forward to working with you as stewards of the scheme, for safety in the system.
