AHPRA sought legal advice on mandatory health checks

If the Medical Board of Australia wants to push through health checks for older doctors, it will have to get sign-off from every health minister in the country.

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In his final Senate Estimates appearance, outgoing AHPRA CEO Martin Fletcher reiterated that the regulator’s proposed health checks for doctors aged over 70 was not an attempt to institute a mandatory retirement age.

Mandatory health checks for older doctors were first put forward as an idea in late 2017, but the Medical Board of Australia did not make any immediate move.

Then three months ago, somewhat unexpectedly, the board opened up a consultation.

It gave stakeholders three options: keep the status quo, institute mandatory comprehensive fitness-to-practice assessments or introduce mandatory GP-run general health checkups.

Under option two and three, doctors would have one checkup or assessment every three years from the age of 70, and then yearly from 80 onward.

By and large, doctors were unimpressed with the idea.

One of the big questions to crop up immediately was whether it could constitute age-based discrimination.

The AMA questioned if the board had sought legal advice on whether the proposed models were ageist.

When The Medical Republic sent questions to AHPRA last month asking whether it had done so, it would neither confirm nor deny.

Speaking at the Community Affairs estimates hearing on Thursday, Mr Fletcher confirmed that it had indeed sought legal advice.

“It is my understanding that we did, but happy to take on notice the nature of the advice we sought,” he said.

He also said that enforcing a mandatory health check for older doctors would likely take the form of a registration standard, which itself would have to be approved by every state and territory health minister in the country.

“I think it’s really important to say that this is not a mandatory retirement age, but it does reflect our data that shows an increased in complaints about the performance of doctors over 70,” Mr Fletcher said.

Over 200 submissions were received as part of the consultation, which closed in early October after a two-month feedback window.

Doctors over the age of 70 represent about 5% of Australia’s practicing medicos, Mr Fletcher said.

Mr Fletcher was also questioned over AHPRA’s streamlined registration pathway for internationally qualified specialists, which officially kicked off last month.

In a nutshell, the new pathway allows doctors who have fellowed in general practice in either the UK, Canada or Ireland to go straight to the Medical Board of Australia for registration rather than going through the specialist medical colleges.

They are required to work under supervision for six months.

When asked who would ultimately be responsible for the safety of practitioners who started working in Australia under the new scheme, he said the “usual processes” would apply to raise concerns about practitioner conduct.

“If there was a concern being expressed about the practice of a medical practitioner, that would be raised by their supervisor in the supervisor reports to the Medical Board of Australia,” Mr Fletcher said.

“That could result in the medical board deciding to continue an extended period of supervision or it could result in the medical board putting additional conditions on the registration that person.”

Council of Presidents of Medical Colleges chair Associate Professor Sanjay Jeganathan said AHPRA had not done enough to ensure that specialists coming in under the scheme would be working in areas of need.

“We cannot accept an implementation approach for international medical registration that fails to address the fundamental challenge of ensuring all Australians have access to appropriate specialist care,” Professor Jeganathan said.

“Regional Australians deserve the same quality healthcare as city residents, yet the current approach risks widening rather than closing these geographical healthcare gaps.”

All doctors who trained internationally, regardless of Australian registration pathway, are barred from billing to Medicare for a decade unless they work in an area of workforce shortage.