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The most significant legislative reforms since the National Registration and Accreditation Scheme (the National Scheme) began in 2010, passed in the Queensland Parliament on 13 October 2022. These reforms reflect Health Minister’s commitment to continually improve the National Scheme to ensure it provides protection for the public in a responsive, accountable and sustainable way.
The Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2022 (the Bill) makes changes to the Health Practitioner Regulation National Law (the National Law) that were agreed to by Australian Health Ministers on 18 February 2022. The Bill was debated and passed by Queensland Parliament in October 2022.
On 21 October 2022, the Bill achieved assent and The Health Practitioner Regulation National Law and Other Legislation Amendment Act (the Act) became law, some changes started on that date with others starting later.
The changes respond to recommendations from several reviews which along with Health Ministers’ responses, can be accessed on Ahpra’s website.
On 20 April 2023, the Health Practitioner Regulation National Law (Surgeons) Amendment Bill 2023 (Surgeons Bill) was introduced into the Queensland Parliament. If passed, the amendments in the Bill will mean only those with specialist surgical training will be able to legally call themselves a ‘surgeon’.
The Health Practitioner Regulation National Law (Surgeons) Amendment Bill has been referred to the Health and Environment Committee for scrutiny.
More than 30 changes are being made to the National Law.
The main objectives of the changes are to:
A summary of the changes and when they will start is provided below.
For detailed information about what is changing and how Ahpra and National Boards will implement the changes, read An information guide: How Ahpra will implement changes to the Health Practitioner Regulation National Law.
The Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2022 (the Bill) was introduced into the Queensland on 11 May 2022. The Bill progresses amendments to the National Law that were agreed by Australian Health Ministers on 18 February 2022 following public consultation.
As Queensland is the host jurisdiction for the National Law, the amendments must be introduced into the Queensland Parliament for review, debate and passage.
The Bill was reviewed by the Queensland Parliament’s Health and Environment Committee. The Committee’s report is accessible on its website.
The Bill was debated and passed by Queensland Parliament on 13 October 2022.
The Health Practitioner Regulation National Law and Other Legislation Amendment Act 2022 became law on 21 October 2022, some changes started on that date with others starting later.
A Factsheet about how a law is made in Queensland is available from the Queensland Government webpage.
Australian Health Ministers agreed to seek changes to the National Law. They also agreed to the Bill that was introduced into the Queensland Parliament. The Queensland Parliament has debated and passed the Bill to bring these changes into law.
There were multiple rounds of consultation with stakeholders, led by jurisdictions over a few years before the Bill was finalised and introduced into Queensland Parliament. The Explanatory Notes to the Bill (pages 26 to 31) provide a good summary of the consultation.
The first group of changes started on 21 October 2022 in all states and territories except Western Australia (see our table).
The second group of changes started on 15 May 2023 (in all states and territories except WA) (see our table).
The remaining changes will start on a date/s to be fixed by proclamation to be decided by government.
The phased approach to starting the changes provides time for Ahpra and the National Boards to prepare for implementation of changes and for the changes to start at the same time nationally. Some of the changes have impacts on our operations and it is important that time is provided to explain these changes to practitioners and the public.
The changes will be applied automatically in each state and territory – except in New South Wales and South Australia where government will make a regulation to confirm the changes and in Western Australia where a corresponding amendment Bill will go through the WA parliamentary process.
The Queensland legislation website hosts the Health Practitioner Regulation National Law and Other Legislation Amendment Act as passed that amends the National Law.
When the Bill was introduced into Queensland Parliament, it had accompanying information to help people understand the changes. The Bill was referred to the Health and Environment Committee and the committee’s webpage provides easy access to the:
You can also access stakeholder submissions and the committee’s report on the Bill.
In January 2023, Ahpra consulted on the new power to issue public statements. You can read the consultation paper and outcomes below.
If you have a question about Ahpra’s implementation of the changes, please email us: [email protected]
Changes that started on 21 October 2022 (assent)
Paramount principle
New paramount principle to provide that the paramount considerations for administering the law are public protection and public confidence in the safety of health services
Cultural safety for Aboriginal and Torres Strait Islander Peoples
New objective and guiding principle to the National Law that acknowledges the National Scheme’s role in ensuring the development of a culturally safe and respectful health workforce that is responsive to Aboriginal and Torres Strait Islander Peoples and their health and that contributes to the elimination of racism in the provision of health services.
Disestablishment of AHWAC
Remove provisions that establish the Australian Health Workforce Advisory Council.
Agency Management Committee
Change the name of Ahpra’s governing body to the Ahpra Board.
Functions of National Agency
Update functions to more accurately reflect Ahpra’s role and responsibilities.
Endorsement as midwife practitioner
Remove endorsement of registration for midwife practitioners.
Advertising offences
Increase the maximum penalty for breaching advertising restrictions.
Directing and inciting offences
Increase the maximum penalties for direct and incite offences.
Mandatory notification by employers
Insert a note in the National Law to clarify when employers must notify Ahpra of potential misconduct by a practitioner-employee.
Prohibition orders
Editorial change to clarify that, if a responsible tribunal decides to cancel a person’s registration or the person does not hold registration, the tribunal may decide to prohibit the person, either permanently or for a stated period, from either or both providing any health service or a specified health service, or from using any title or a specified title.
Minor amendments
Minor / technical changes to the National Law – for example to correct typographical errors.
(other minor and technical changes will start on proclamation)
Undertakings
Allow National Boards to accept an undertaking from a person when deciding the person’s application for registration.
Conditions
Clarify how conditions on endorsements of registration can be removed or changed.
Withdrawal of registration
Allow National Boards to withdraw a practitioner’s registration if it was improperly obtained because of the provision of false or misleading information or documents.
Scheduled medicines offences
Require registered health practitioners and students to report offences related to regulated medicines and poisons to the relevant National Board
Previous practice information (these changes are best read together)
Enable a National Board to give written notice of decisions made under the National Law to other registered health practitioners with whom a registered health practitioner shares premises or has a ‘practice arrangement’. This includes those who have an employment relationship or an agreement with the practitioner to provide services on behalf of the entity, whether in an honorary capacity, as a volunteer, or otherwise. A National Board will also be able to give written notice of decisions to registered health practitioners or entities who had previously had a practice arrangement with the practitioner where there is a risk of harm or risk to public safety.
Notification of employers to protect the public
Allow National Boards to disclose information to employers or certain other associates about serious risk posed by a registered health practitioner who is the subject of a notification or investigation about their health, conduct or performance. Information can be disclosed (provided the threshold test is met) to other registered health practitioners with whom the practitioner currently shares premises or to an entity that has a current ‘practice arrangement’ with the practitioner.
Disclosure of information about unregistered practitioners
Enable National Boards to disclose information about serious risk posed by an unregistered person who is being investigated or prosecuted under the National Law. Information can be disclosed (provided the threshold test is met) to other registered health practitioners with whom the unregistered person currently shares premises or to an entity that has a current ‘practice arrangement’ with the unregistered person.
Disciplinary action in relation to health practitioners while unregistered
Allow National Boards to take disciplinary action against practitioners who continue to practice or use a protected title after their registration has lapsed.
Requirement to provide records for preliminary assessment
Allow National Boards to require the provision of information or production of documents for the purpose of conducting a preliminary assessment of a notification.
Allow a prohibition order issued by a tribunal to impose restrictions on a practitioner’s provision of health services, in addition to the current ability to prohibit the provision of specified health services or the use of a title. Aligns prohibition orders with interim prohibition orders and provides further flexibility for tribunals.
Public statements
Allow Ahpra and National Boards to issue a public statement if necessary to protect the public (provided the threshold test is met).
Referral to other entities
Allow National Boards to refer matters to another entity after a preliminary assessment of a notification.
Show cause processes
Allow a National Board to change its proposed disciplinary action after undertaking a show cause process.
Discretion not to refer matters to responsible tribunal
Allow National Boards to decide not to refer matters to a tribunal where there is no public interest in such a referral.
Consequential changes
Amendments to s.109 (Annual statement) and s.130 (registered health practitioner or student to give National Board notice of certain events) – refer to Health Insurance Act rather than repealed Medicare Act.
Ministerial Council
Amend the definition of Ministerial Council to reflect current governance arrangements for intergovernmental relations.
Allow the Ministerial Council to delegate its power to approve registration standards only.
Commencement of registration
Allow the commencement of specialist, provisional, limited and non-practising registrations to be post-dated up to 90 days after a registration decision is made (in the same way that general registration is).
Renewal of registration during suspension period
Clarify the time in which a practitioner must renew their registration once a period of suspension has ended.
Interim prohibition orders
Allow Ahpra and National Boards to issue interim prohibition orders to unregistered practitioners, or to practitioners whose registration has lapsed or been suspended (provided the threshold test is met).
Use of an alternative name
Allow practitioners to include an alternative name on the public register (general and specialist) and require them to only use a name that is on the register when they practise.
A National Board may be enabled to refuse to include an alternate name for a practitioner for a range of reasons, including if it is obscene or offensive; could not practicably be established by repute or usage because, for example, it is too long, uses symbols without phonetic significance, or includes a statement or phrase; or if it includes or resembles an official rank or title or a protected or specialist title in the National Law.
Exclusion of information from register
Allow National Boards to exclude information from the public register if publication of the information poses a risk to the health and safety of the practitioner, their family, or their associates.
Other minor changes
Change to definition of suspension period.
Replacing phrases indicating that a person can inspect a document held by a regulator at a ‘reasonable time and place’ with a reference to ‘at a reasonable time and in the reasonable way’ decided by the Board; these changes reflect that the inspection and copying of documents is now often done electronically, rather than in person.
Change to the National Law removed from Bill (change will not be made)
Advertising (testimonials) – withdrawn
The change to lift the blanket ban on use of testimonials in advertisements of regulated health services was withdrawn from the Bill. This means that the current ban will remain in place.