Academic journal article Australian Health Review

National Registration Scheme at 5 Years: Not What It Promised

Academic journal article Australian Health Review

National Registration Scheme at 5 Years: Not What It Promised

Article excerpt

Introduction

After 5 years experience of the national registration scheme, it is time to examine what the scheme has delivered. In 2009, it was suggested that the proposed scheme was a model fraught with problems and that it was being implemented too hastily.1 The negative effect of that haste was documented in a 2011 Senate inquiry,2 and further experience has confirmed problems with the scheme.3 This review briefly recalls the premises on which the Productivity Commission recommended a national system, the aims declared by the Council of Australian Governments (COAG) and the intentions of the interim implementation authority. It also examines the Independent Review of the National Registration and Accreditation Scheme for Health Professions report,4 commissioned by COAG, and COAG's response to the report,5 both of which were recently made public. I then pose, and attempt to answer, several questions, with particular focus on the scheme's impact on the medical profession. My critique is not directed at members of the Medical Board of Australia (MBA), its state boards or staff of the Australian Health Practitioners Registration Authority (AHPRA), who strive to deliver services consistent with the National Law.

The Productivity Commission

The study conducted by the Productivity Commission was requested in March 2005. Its report, Australia's Health Workforce Research Report, was dated December 2005.6 Given its breadth and potential importance, this was hasty. Its scope encompassed:

* factors affecting the supply of health workforce professionals

* the structure and distribution of the health workforce, and the consequences for its efficiency and effectiveness

* factors affecting demand for services provided by health workforce professionals

* the specific health workforce needs of rural, remote and outer metropolitan areas and issues of Indigenous health

* advice on the identification of, and planning for, Australian health care priorities and services

* advice on the issue of general practitioner (GP) services in or near hospitals on weekends and after hours.

The Productivity Commission recommended a single national accreditation agency and a separate single national registration board for all health professionals. Although a national approach was eventually agreed by COAG, these specific recommendations of the Productivity Commission were not acted upon.

The COAG agreement

In March 2008, COAG announced that the medical profession and eight other health professions would be included in a national accreditation and registration scheme as of 1 July 2010.7 The objectives of the scheme, to be set out in new legislation, were to: * provide for the protection of the public by ensuring that only practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered

* facilitate workforce mobility across Australia and reduce red tape for practitioners

* facilitate the provision of high-quality education and training, as well as rigorous and responsive assessment of overseastrained practitioners

* have regard to the public interest in promoting access to health services

* have regard to the need to enable the continuous development of a flexible, responsive and sustainable Australian health workforce, and enable innovation in education and service delivery.

In subsequent months, the Australian Health Workforce Ministerial Council announced additional elements of the scheme, including mandatory reporting, criminal checks, student registration and broadening the scope of health programs for doctors.8 More recently the number of health professions included has risen to 14.

The implementation authority

In the October 2008 consultation paper9 issued by the Australian Health Ministers' Advisory Council, one of the principles espoused was to 'build on the best aspects ofthe State and Territory schemes'. …

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