Academic journal article Australian Health Review

Approaches to Management of Complaints and Notifications about Health Practitioners in Australia

Academic journal article Australian Health Review

Approaches to Management of Complaints and Notifications about Health Practitioners in Australia

Article excerpt


Government regulation of health practitioners and the protective nature of regulation are central public policy precepts, but are variously challenged by competing arguments for greater competition, self-regulation and recognition of global health workforce mobility.1 Regulatory modalities have also undergone change,2 broadening from command and control models to embrace other forms of governance, such as risk-based approaches,3 codes of practice and individualised (non-uniform) strategic regulation.4 Evidence-based assessment of where the balance of advantage lies in these debates is vital. Historically, complaints/notifications against registered health practitioners in Australia have been processed by a mix of state- and territoryspecific self-regulated registration boards, supplemented in the past 30 years by internal review processes of organisational providers and external entities, such as independent complaint commissioners or Ombudsmen.

TheNational Registration andAccreditationScheme(NRAS) for health practitioners came into effect in 2010 in all states and territories and is governed by the Health Practitioner Regulation National Law (the National Law). The legislation commenced with inclusion of 10 National Boards representing regulated health professions, with a further four professions joining the NRAS in 2012. These 14 health professions are now regulated by nationally consistent legislation in terms of registration and accreditation.

A key objective of the NRAS is to protect the public (Health Practitioner Regulation National Law,; verified 20 July 2015). For the first time in Australia, 'complaints' (in NSW) or 'notifications' (under the NRAS) against health practitioners for all states and territories are managed under the one scheme, except New South Wales (NSW), which retained its existing coregulatory complaint-handling system. In 2014, Queensland (Qld) withdrew from the NRAS for complaint/notification handling,5 and introduced a coregulatory system similar to that in place in NSW. The Victorian Parliament also commissioned an inquiry in 2013 into complaint/notifications handling in their State, which recommended that further examination be undertaken of the coregulatory complaint/notifications-handling model operating in NSW.6

This article describes the governance structures underpinning complaint/notifications handling in relation to complaint/notifications made specifically about health practitioners that were introduced with the inception of the NRAS. It explores the similarities and differences in complaint/notification-handling mechanisms for NSW compared with the rest of Australia. The retention of the coregulatory scheme in NSW resulted in two complaint/notifications-handling systems running concurrently in Australia and now a third scheme, the Queensland Health Ombudsman, has added another model, albeit similar in function to the NSW Health Care Complaints Commission (HCCC). The Queensland Health Ombudsman is in the establishment phase and thus will not be discussed in any detail in relation to this comparative analysis.

The National Law and governance structures

In 2008, the Council of Australian Governments agreed to establish an NRAS for health practitioners by 2010. The NRAS took effect from 1 July 2010 following the adoption of the National Law (hosted by passage of an Act in Queensland),7 which was then adopted for commencement of the scheme on 1 July 2010 in all states and territories except Western Australia, which joined the NRAS on 18 October 2010. This original legislation is the Health Practitioner Regulation National Law Act 2009 (Qld), herein referred to as the National Law, with any jurisdictional variants differentiated by the name of the Act and jurisdiction. Overseen by a Ministerial Council (The Australian Health Workforce Ministerial Council), key components of the NRAS are the National Boards (one for each registered health profession included in the scheme), accreditation authorities for each health profession in the scheme and the Australian Health Practitioner Regulation Agency (AHPRA) and its governing body, the Agency Management Committee. …

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