The RACGP would prefer that all information published about a doctor on the register have an expiration date, in line with the Spent Convictions scheme.
The AMA has raised concerns that serious sexual misconduct by health practitioners, which is proposed to be published in perpetuity, has no definition, while the RACGP has argued that publication should have an expiry date in line with the Spent Convictions scheme.
Speaking to Queensland’s Health Environment and Innovation Committee today on the Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2024, AMA president Dr Danielle McMullen raised some concerns.
In February 2023, following media reports of health practitioners reoffending after being found to have committed sexual misconduct or a sexual boundary violation, state and federal health ministers committed to reforms.
The proposed reforms involved changes to the Health Practitioner Regulation National Law, consultation on which ended last year.
Arguably the biggest amendment was requiring the national board to publish a practitioner’s full regulatory history if they were found to have committed sexual misconduct or a sexual boundary violation.
The AMA and the RACGP expressed concerns over a practitioner’s entire regulatory history being permanently published. The AMA called for the scope to be narrowed to publication of sexual boundary violations or sexual misconduct only.
At a health ministers meeting in Brisbane in April last year, the ministers backed reforms to publicise proven serious sexual misconduct allegations in perpetuity.
The AMA has been supportive of the proposal but has called for a consistent definition of what would trigger publishing, through consultation.
“The main point we wanted to raise is that these powers [to publish in perpetuity] need to be used judiciously, and for that to occur the tribunals obviously need clarity around definitions and what would be an appropriate threshold [of serious sexual misconduct] so that both the tribunals understand how they’re expected to act, but also doctors under investigation have an understanding of what to expect and to help protect their wellbeing under investigation,” Dr McMullen told the Committee today.
Dr McMullen pointed to the Medical Board’s definitions of sexual boundaries in the doctor-patient relationship as a reference point.
She also called for, at a minimum, evaluation going forward on how often these powers were used and practitioner experience.
Noting the significant impact that AHPRA investigations have had and continue to have on doctors, Dr McMullen emphasised the “real gravity of permanent information on the register”.
“It has a significant impact on the life of a doctor if there is information about them published on the register, and that is feedback that we get from our members and from doctors around the country,” she said.
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“I would suggest that people are reading [the register] and it is having an impact on the working lives of these doctors if they’ve noticed a change in their relationships with referred patients and referrers once that information is public.
“We do think it has a significant impact on the working lives of those doctors, and therefore not something to be taken lightly.”
But the AMA did not oppose the bill, said Dr McMullen, and they did not condone any conduct that breached the trust that the community had in their medical practitioners.
They urged caution over the use of the powers, which should be used “sparingly and proportionately with the conduct”.
The AMA supported that in the case of reinstatement onto the register after being struck off, that cases go through the tribunal which was involved in the original decision to remove a doctor, before going to the National Board, to ensure that the original facts of the case were fully considered.
This aligns with how the process currently operates in New South Wales.
“The primary thing we want to achieve is national consistency,” said Dr McMullen.
“But we are not opposed to following a NSW model, where the jurisdiction or the tribunal who had coverage over the original case also has a role in the reinstatement process.”
The association also said at least one month should be provided for consultation, which did not occur in this case.
RACGP president Dr Michael Wright said the college also had some concerns about retaining information on the register in perpetuity.
He said the college’s position was that “it may be appropriate to publish information for a set period and then remove it from the register once it expires, which would be a similar approach to the Spent Conviction scheme”.
The college did not have a firm position on a suitable expiry date for public publication.
The RACGP also supported a nationally consistent requirement for practitioners to seek a reinstatement order if their registration had been cancelled or they had been disqualified from practicing.
“We also welcome greater protections for notifiers and those who assist regulators during investigations about health practitioners and members do not support non-disclosure agreements in the context of a sexual boundary violation or sexual misconduct,” he said.
“Our members don’t support non-disclosure agreements in the context of sexual boundary violation or sexual misconduct.
“However, if an NDA is made, the affected person should be informed that they can still make a notification to AHPRA or another regulatory body … Rather than making it an offense not to inform an effective person of their right to make a notification, it’d be simpler just to make the NDA clauses void if a notification advice is not given.”