The college did not directly comment on whether a single national tribunal should replace the current mash of eight, one from each state and territory.
The RACGP is renewing calls for an overhaul of AHPRA’s notification process, as it says anecdotal evidence of changes doesn’t suffice.
Last week, the RACGP released its submission to the independent review into the complexity of the National Registration and Accreditation Scheme, responding to the first consultation paper from the review.
The consultation paper aimed to stimulate “spirited discussion” by laying out broad directions for the reform of AHPRA, which has been scrutinised countless times over its14-year lifespan.
“The initiation of this review against a backdrop of a long history of reviews tells its own story … it also suggests a history of weakness in the use of regulatory intelligence to proactively pursue workforce and regulatory reform,” the review lead and former NSW Health Care Complaints Commissioner Sue Dawson said.
In its response to the consultation, the RACGP renewed calls for an overhaul to the notification system and said it supported a system “that balances patient safety with sensible processes that do not unduly impact the delivery of high-quality care”.
The college’s submission highlighted AHPRA’s perceived disregard for doctor’s wellbeing and the lacklustre triage processes, notably in relation to vexatious complaints.
“There are several issues with the management of notifications, including those deemed high-risk,” said the report.
“These include timeframes for cases to be resolved, reputational damage and a lack of support provided to doctors.
“The impact of vexatious notifications on practitioners should not be underestimated, even if these are eventually dismissed.”
In her cover letter, RACGP president Dr Nicole Higgins said a reoccurring theme among member was a lack of trust in AHPRA.
“This is a significant issue when expecting GPs to accept regulatory decisions and policy changes,” she said.
“Our members are particularly keen to see improvements made to complaints processes given the mental health impacts of vexatious complaints and delays in investigating/managing complaints.”
The college recognised that AHPRA had “reportedly taken steps” to revamp its triaging practices.
But “solid data is needed to demonstrate whether processes have indeed improved” as anecdotal hearsay was not enough, said the college.
“The effective management of complaints is complex, requires a particular skill set, consistent application of methodology and industry knowledge,” it said.
“The triage and management of complaints should be sophisticated enough to afford timely review and outcomes.
“However, even more important than timeliness is that all parties to the complaint have confidence that the process observes the traditional principles of natural justice, objectivity, consistency and confidentiality.”
The college said that the efficiency of the initial assessment could be improved by first considering whether a practitioner had already been “deemed to pose a threat to patient safety”.
“These clinicians often have multiple areas of concern, or have multiple reports made against them,” said the college.
“This does not mean that all complaints are not taken seriously, however triaging could be improved according to the risk posed to patients and the likelihood of a particular allegation being true.”
Related
The review also queried whether the eight separate state and territory tribunals for doctors could be replaced by a single national tribunal, which received “strong advocacy” from within AHPRA according to the consultation paper.
The college did not touch on this directly but spoke to its calls for an overhaul of the notifications process.
Regarding a “single front door for lodging complaints within state and territory health complaints entities”, the RACGP said it supported simplification of complaints handling in principle.
It said it would need additional information on costs and benefits of a single front door platform and raised some concerns.
“A single front door for each jurisdiction without harmonisation may exacerbate inconsistencies in the assessment, management and processing timeframes of complaints,” it said.
“Adequate resources and national consistency with regional supports is likely to deliver better outcomes.”
The second consultation paper is due to be released in January, with the final report due to be delivered to health ministers in April 2025.
