Simplifying AHPRA could mean fewer boards, centralised tribunal

The healthcare regulator is in the process of getting a nip and tuck.

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The Health Chief Executives’ forum deep dive into the complexities of AHPRA has surfaced its first consultation paper, which outlines a vision of a leaner and more efficient regulator.

AHPRA itself has been the subject of near-constant reviews over its 14-year life, a fact which did not escape independent review lead Sue Dawson.

“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 former NSW Health Care Complaints Commissioner said.

The consultation paper laid out three broad reform directions: repositioning the national regulation scheme by applying a stewardship model, resetting accountabilities within and alongside other national scheme entities and moving toward a fully integrated three-tier model of regulation.

It stressed that nothing was set in stone as a recommendation yet and that the reform directions were simply to “help stimulate spirited discussion and to help promote thinking”.

Applying a stewardship model would involve strengthening the “strategic connection” between national workforce strategy and AHPRA so that regulation worked closer with the broader workforce agenda.

The reforms listed under “resetting accountabilities” would likely have more immediate implications for average healthcare workers.

Under this reform direction, the national boards would have more of a focus on developing policies and standards while AHPRA would have a “fuller responsibility for day-to-day notification handling” and decisions.

The final reform direction deals mostly with deciding which professions should be regulated and suggests developing a voluntary register for some non-regulated professions, similar to the UK’s former model of voluntarily registered physician associates.

All told, the consultation paper comprises a hefty 111 pages.

The consultation paper submission template, at the somewhat more reasonable length of six pages, gives further insight into the review.

Its questions include whether there are opportunities to reduce the number of boards and committees within the national scheme, and it also calls for views on whether a single national health practitioner tribunal could replace the eight separate state and territory tribunals.

This last is mentioned only briefly in the consultation paper itself, as part of a discussion on AHPRA’s concerns that tribunal decisions are inconsistent across jurisdictions.

The review was unable to assemble a “sufficiently broad sample of case decisions” to determine the nature or extent of any potential inconsistencies but acknowledged a need for further analysis and the “strong advocacy” from within AHPRA for a single national tribunal.

Submissions close on 14 October, with a second issues paper to be provided in the coming months.

The final report will be delivered to health ministers in April 2025.