April 2015

• Chair’s message
• Improving the notifications process 
  • We are working on a fair and timely process with clear information
• Update on National Scheme review 
  • Health ministers to consider the review report in August
• Consultations 
  • Still time to tell us what you think of the Board’s proposed cosmetic surgery guidelines
  • Call for views on our regulatory principles
• Accreditation 
  • Providing high quality education and training
• News and alerts 
  • Misleading website taken down
  • June 2015 change to acupuncture endorsement arrangements 
• Panel, court and tribunal decisions 
  • Latest tribunal decisions published online 
• Contacting the Board 

Chair's message

A key aspect of the Medical Board's role is dealing with notifications about registered medical practitioners. We need to assess and manage these in a way that is fair, transparent and effectively manages risk to patients where a doctor's conduct or performance is unsatisfactory.

We know that being on the receiving end of a notification is very distressing and confronting. We know that there are things the Board and AHPRA can do to improve the experience of practitioners and notifiers involved in the notifications process, while holding our focus on patient safety. We are working on this. Last month we joined forces with the AMA to hear their views and work together to identify problems and solutions. We will keep you informed about our progress. 

Dr Joanna Flynn AM
Chair, Medical Board of Australia

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Improving the notifications process

We are working on a fair and timely process with clear information

A recent workshop with leaders from the Board, AHPRA and the Australian Medical Association (AMA) focused on improving practitioners’ experience of the notifications process.

One of the important features of regulation is assessing and managing concerns raised about registered medical practitioners. When assessing a complaint (notification), the Board and AHPRA consider whether there is a risk to public safety that needs to be managed. Sometimes, investigations are needed. The Board understands that medical practitioners who are the subject of a notification can find the assessment and investigation process difficult and stressful. The workshop identified further actions AHPRA can take to improve the experience of practitioners who are subject to a notification, while maintaining patient safety.

The workshop involved the Board Chair, senior leaders from AHPRA and representatives from the AMA. There was a common commitment to constructive change and a spirit of goodwill. The Board is grateful to the AMA for sharing their ideas and working together to make things better for practitioners, in a fair process with clear information.

AHPRA’s earlier work has focused on changes to improve the experience of notifiers. The same issues face both notifiers and practitioners who are the subject of a notification, so changes aim to improve the experience of everyone involved.

Key issues we are working on include the time it takes for a notification to go through the process; the tone and clarity of our communication; the need to better explain how the process works and why; and greater transparency about what information can be legally released.

Some of the areas we will be focusing on next will be to:

• review the letters we send to practitioners who are the subject of a notification to improve the tone and make the information clearer
• ensure we share our regulatory principles with all initial notifications correspondence. These principles guide all decision-making in the National Registration and Accreditation Scheme and are shared by National Boards and AHPRA
• communicate more frequently with practitioners when an investigation takes more than 12 months. Public information needs to explain what some of the causes of lengthy delays are, such as coronial inquiries and court cases
• update the Guide to notifications, and
• seek feedback from practitioners at the end of the notifications process, so we can keep improving.

For more information, AHPRA has published guides for practitioners on the notifications process.

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Update on National Scheme review

Health ministers to consider the review report in August

Federal and state and territory health ministers will respond to the report of the review of the National Scheme in August this year.

Ministers met in mid-April at the COAG Health Council to discuss a range of national health issues, including the final report of the National Registration and Accreditation Scheme (NRAS) Review. The independent review was conducted by Kim Snowball, the former Director General of Health in WA. It involved an extensive consultation process that included more than 230 written submissions and more than 1,000 individuals participating in consultation forums in each capital city.

The review aimed to identify what was working well in the National Scheme and opportunities to improve and strengthen our work to protect the public and facilitate access to health services. According to the report of the meeting, health ministers will consider the recommendations from the NRAS Review and discuss them further at their meeting in August 2015.

The COAG Health Council communiqué is available on the COAG Health Council website.

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Consultations

Still time to tell us what you think of the Board’s proposed cosmetic surgery guidelines

Last month, the Medical Board released a consultation paper asking for feedback on the best way to protect consumers seeking cosmetic medical and surgical procedures provided by medical practitioners.

The Board has put forward four options to better protect consumers in this area of medical practice. The options range from doing nothing, developing consumer education material, through to providing general guidance to medical practitioners or specific guidance to medical practitioners who provide cosmetic procedures.

The issues and options are outlined in the public consultation paper and regulation impact statement.

A regulation impact statement (RIS) details the costs and benefits of proposed options and is required by the Commonwealth’s Office of Best Practice Regulation. The RIS provides detailed background information on this issue, including evidence, regulatory context, non-regulatory and regulatory options and the associated impacts, costs, benefits and risks.

Guidelines for registered medical practitioners who provide cosmetic medical or surgical procedures are the Board’s preferred option for managing risk to patients. The draft guidelines propose:

• a seven-day cooling off period for all adults before procedures other than minor procedures that do not involve cutting beneath the skin
• a three-month cooling off period before procedures for all patients under 18, along with mandatory assessment by a registered psychologist or psychiatrist
• explicit guidance on informed patient consent, including clear information about risks and possible complications
• explicit responsibility for postoperative care by the treating practitioner, including emergency facilities when sedation or analgesia is involved
• mandatory face-to-face consultations before prescribing schedule 4 (prescription only) cosmetic injectables
• detailed written information about costs, and
• limits on where cosmetic procedures can be performed, to manage risk to patients.

Feedback

The Board is keen for feedback on the four options including the draft guidelines. The consultation paper is available on the consultation page of the Board’s website.

Please provide written submissions by email, marked ‘Consultation – Cosmetic medical and surgical procedures provided by medical practitioners’ to medboardconsultation@ahpra.gov.au by close of business 29 May 2015.

We usually publish submissions to consultations. More information about the consultation process is available in the consultation paper.

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Call for views on our regulatory principles

National Boards and AHPRA are seeking feedback through an online survey* on the regulatory principles that were launched in July last year.

The Regulatory principles describe the National Boards and AHPRA’s approach to regulation. The principles encourage a responsive, risk-based approach to regulation and support consistent, balanced decision-making. The aim of the principles is to foster a considered approach to regulation, reducing the risk of unnecessary and ineffective regulatory action, and focussing resources on areas where the result is harm minimisation. We are inviting members of the public, health consumers, health practitioners and all interested persons to share their views on our regulatory principles through this brief survey. The survey has 11 questions and should only take about five to ten minutes to complete.

The responses to these surveys will inform the ongoing implementation of the principles and how they could be further developed and improved.

Complete the survey by 9am Monday 18 May by following the link above, or by pasting this address to your web browser: https://www.surveymonkey.com/r/LXQTHHL*

*Privacy: When you click on this link, you will be taken to a survey on a third party website, hosted by SurveyMonkey. AHPRA is conducting the survey. The survey is anonymous. Responses to the survey will be used to review the Regulatory principles for the National Scheme. The information you provide will be handled in accordance with the privacy policies of Survey Monkey. Information AHPRA obtains from the survey will be handled in accordance with our Privacy policy.

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Accreditation

Providing high quality education and training

One of the objectives of the National Law is to facilitate the provision of high quality education and training of health practitioners. The accreditation function is the primary way of achieving this. More information about the Medical Board’s accreditation function is available on our Accreditation page.

Monash University

After receiving accreditation advice from the Australian Medical Council, the Board approved a change of name to the accredited medical programs of Monash University from Bachelor of Medicine/Bachelor of Surgery (MBBS) to MBBS (Hons). The accredited medical programs (MBBS (Hons)) of Monash University remain approved until 31 December 2017.

University of Adelaide

After receiving accreditation advice from the Australian Medical Council, the Board approved the accredited six-year Bachelor of Medicine/Bachelor of Surgery (MBBS) program of the University of Adelaide as providing a qualification for the purposes of general registration until 31 March 2018.

Griffith University

After receiving accreditation advice from the Australian Medical Council, the Board approved the following accredited medical programs of Griffith University as providing qualifications for the purposes of general registration:

• Doctor of Medicine (four year degree) until 31 March 2021
• Bachelor of Medicine/Bachelor of Surgery (four year degree) until 31 December 2017.

Flinders University

After receiving accreditation advice from the Australian Medical Council, the Board approved the following accredited medical programs of Flinders University as providing qualifications for the purposes of general registration:

• Doctor of Medicine (four year degree) until 31 March 2021
• Bachelor of Medicine/Bachelor of Surgery (four year degree) until 31 December 2017.

Royal Australasian College of Physicians

After receiving accreditation advice from the Australian Medical Council, the Board approved the accredited specialist training programs and the accredited continuing professional development programs of the Royal Australasian College of Physicians (RACP) leading to fellowship of the RACP as providing qualifications for the purposes of specialist registration until 31 March 2021.

Australian College of Rural and Remote Medicine

After receiving accreditation advice from the Australian Medical Council, the Board approved the accredited specialist training pathways and the continuing professional development program of the Australian College of Rural and Remote Medicine (FACRRM) as providing a qualification for the purposes of specialist registration until 31 March 2018. 

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News and alerts

Misleading website taken down

A potentially misleading website that republished information from AHPRA’s register of practitioners without permission is no longer published online.

Some practitioners had raised concerns about the ‘Doctor inspector’ website, which published selective information sourced from the public register of practitioners without practitioners’ consent.

AHPRA had not given permission for the use of information from the public register by the website. Its operators appeared to have used technology known as screen scraping to automatically pull information from the public online register and republish it in a different context.

The ‘Doctor inspector’ website is no longer published on the internet.

AHPRA’s online register is the only accurate and up to date source of information about the registration status of Australia’s 633,500 registered health practitioners.

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June 2015 change to acupuncture endorsement arrangements

June 2015 will see the end of arrangements allowing some medical practitioners without approved qualifications to become endorsed for acupuncture.

The title ‘acupuncturist’ is a protected title under the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law). Registered medical practitioners who wish to also call themselves an ‘acupuncturist’ must have their registration endorsed for acupuncture by the Medical Board or also hold registration with the Chinese Medicine Board of Australia.

The requirements for medical practitioners who wish to have an endorsement on their registration for acupuncture are set out in the Medical Board’s registration standard Endorsement of registration for acupuncture for registered medical practitioners. The standard includes arrangements that apply until 30 June 2015, for certain medical practitioners who do not have an approved qualification to become endorsed for acupuncture.

From 1 July 2015, only medical practitioners with general or specialist registration, who also hold an approved acupuncture qualification, can apply for endorsement of registration for acupuncture with the Medical Board.

The approved qualifications are:

• Graduate Certificate in Medical Acupuncture (Monash University), or
• The Australian Medical Acupuncture Course.

Applicants with either of the above approved qualifications are also required to successfully complete the Fellowship of the Australian Medical Acupuncture College (FAMAC) Part 1 written and clinical examinations.

The arrangements allow medical practitioners with general or specialist registration who do not hold one of the above approved qualifications to apply for endorsement of acupuncture until 30 June 2015 if they:

1. were accredited by the Joint Consultative Committee on Medical Acupuncture as at 30 June 2012 and they have fulfilled the continuing professional development requirements for medical acupuncture for the previous triennium, or
2. have claimed 25 or more acupuncture-related Medicare item numbers in the period 1 July 2010 to 30 June 2012 and they provide written confirmation of these claims and provide permission for the Board to communicate with Medicare to confirm this information.

Acupuncture-related Medicare item numbers refer to item numbers 173, 193, 195, 197 or 199.

These arrangements end on 30 June 2015. From 1 July 2015, only medical practitioners with an approved qualification for acupuncture can apply for endorsement.

For more information, see the Board’s registration standard Endorsement of registration for acupuncture for registered medical practitioners.

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Panel, court and tribunal decisions

Latest tribunal decisions published online 

AHPRA on behalf of the 14 National Boards publishes a record of panel, court and tribunal decisions about registered health practitioners. Summaries are published when there is clinical and educational value.  

Court and tribunal decisions

Under the National Law, the Board must refer a matter about a registered medical practitioner or student to a tribunal if the Board reasonably believes that the practitioner has behaved in a way that constitutes professional misconduct; or the practitioner’s registration was improperly obtained because the Board was given false or misleading information. The Board must also refer the matter to a tribunal if a panel established by the Board requires the Board to do so.

Medical practitioners may also appeal certain decisions of the Board to a tribunal or court.

AHPRA publishes summaries of tribunal or court cases. These can be sourced at Publications>Tribunal decisions on the AHPRA website. A full library of published hearing decisions from tribunals or courts relating to complaints and notifications made about health practitioners or students is available on the Austlii website.

Recent decisions of tribunals:

Medical Board of Australia and Myers

The State Administrative Tribunal of Western Australia has fined Dr John Barry Myers $10,000 and disqualified him from applying for registration as a medical practitioner for five years. Read more in the media release.

Medical Board of Australia and Palaniappan  

The State Administrative Tribunal of Western Australia has found Dr Jai Palaniappan engaged in professional misconduct. He was reprimanded and fined $4,000 for falsifying registration documents. Read more in the media release.  

Taj v Medical Board of Australia

The Victorian Civil and Administrative Tribunal has affirmed a Medical Board of Australia decision to refuse Dr Salahuddin Taj’s application for specialist registration. Read more in the media release.

Panel hearings

When investigating a notification, state and territory committees of the Medical Board of Australia may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing.

Under the National Law, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Summaries have been provided when there is educational and clinical value. These summaries are accessible from hyperlinks within the table. Practitioners' names are not published, consistent with the requirements of the National Law. This table does not include summaries of panel decisions made under previous legislation, even if these were held after July 2010.

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Contacting the Board

• The Medical Board of Australia and AHPRA can be contacted by phone on 1300 419 495.
• For more information, see the Medical Board of Australia website and the AHPRA website.
• Lodge an enquiry form through the website under Contact us at the bottom of every web page.
• Mail correspondence can be addressed to: Dr Joanna Flynn AM, Chair, Medical Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

More information

Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.

Comment on the Board newsletter is welcome and should be sent to newsletters@ahpra.gov.au.

For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).

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