Issue 7 / 28 February 2011

THE Australian Health Practitioners Regulation Agency has been controversial since it was first mooted nearly 10 years ago.

Concerns about rolling all state-based medical boards into one big national register of all health practitioners have ranged from the practical (“Will it cost more?”) to the frankly whimsical (“Will an undifferentiated workforce run around in Mao suits fighting over who gets to do colonoscopies?”).

But the federal government’s grand plan for a safer, more mobile and responsive workforce also had appeal.

When the register was first proposed, Australian health care was reeling from the Jayant Patel case in Bundaberg, which highlighted the weaknesses inherent in multiple regulatory bodies acting in silos: the Queensland authorities who registered Patel were unaware of his terrible track record in the United States. Surely anything that made this situation less likely was worth supporting.

And doctors who worked in more than one jurisdiction also wanted national registration instead of having to deal with multiple registrations to do essentially the same work in different states or territories.

But 8 months after the introduction of the new national register, things are not looking so simple, safe and streamlined — and it’s not just doctors who have been affected.

A report in The Age stated that “thousands” of Victorian health professionals — nurses and midwives, pharmacists, physiotherapists, dentists, psychologists, optometrists, osteopaths, chiropractors and podiatrists — were either unable to work or were doing so illegally after missing their registration deadline.

Anyone who has attempted the registration process will appreciate why these unfortunate practitioners missed their deadline.

My own bizarre experience with AHPRA was mirrored by many of your responses, and there are a growing number of similar anecdotes from frustrated health professionals of all ilks on sites like Facebook and NurseCentral.

Nobody envied AHPRA the job of combining the databases of about 80 different state and territory boards but the problems with the agency seem to extend far beyond data integrity.

The AMA has collected an impressive list of “major concerns with the AHPRA process”, which include everything from misspelt names and incorrect qualifications, to lost renewals, ad hoc and incorrect advice from AHPRA staff, processing delays, and difficulties in establishing both written and verbal communication with the agency.

Some of these problems have prevented valid registrants from registering. And from working!

The most disappointing aspect of all this is that, having subjected ourselves to a new bureaucracy, substantially increased fees and a very bad case of teething problems, it’s hard to imagine that an organisation that loses a large proportion of its mail and sends multiple emails and text messages in error could save us from another Bundaberg tragedy.

In fact, with all the current turmoil, any rogue practitioner could probably have a field day.

On 17 February, a communiqué came from the Australian Health Workforce Ministerial Council.

Although upbeat about the number of renewals and new registrations achieved, the health ministers agreed that “action needed to be taken to address these concerns and restore professional confidence in the new National Registration and Accreditation Scheme for health practitioners” and that “additional support and expertise” would be provided to AHPRA to achieve this. Importantly, there is now also a “fast track” process for lapsed registrations.

The communiqué did not elaborate on the sort of assistance that will be provided to the beleaguered agency. Obviously, a few more staff to man the phones and to process renewals would be a good start.

But AHPRA, at this point, appears to have failed to grasp the nature of the sector it is trying to regulate — that we pretty much all like the idea of a safe, responsive and flexible health workforce.

Let’s hope that those charged with improving AHPRA’s performance will stop and listen to the various professional bodies that it exists, in part, to serve.

Heaven help us if they don’t.

Dr Ruth Armstrong is a deputy editor with the MJA. She is also a successfully registered medical practitioner.

Posted 28 February 2011

6 thoughts on “Ruth Armstrong: Regulating the regulation agency

  1. Paul d'Arbon says:

    I was asked to renew my registration with AHPRA and my name on the registration form was “Paul John d’Arbon Oam”
    After many frustrating phone calls I finally spoke to an operator explaining that “Oam” should have been “OAM” and she told me she had never heard of the Order of Australia
    I eventually discovered that AHPRA’s phone calls are answered by a service company called Stellar.
    It would appear that I may become rgistered as Dr Paul Oam.
    I wrote to Dr Joanna Flynn, chair of the Medical Board of Australia, on 25 November 2010 about the problem but have not had a reply to or acknowledgment of my letter.

  2. Alias says:

    “And doctors who worked in more than one jurisdiction also wanted national registration instead of having to deal with multiple registrations to do essentially the same work in different states or territories.”
    I registered in three states in less time than it took me to register once for the national scheme

  3. Horst Herb says:

    AHPRA “outsourced” their phone inquiries to a call centre company. While their performance so far certainly does not create confidence in them, such outsourcing certainly would take the crown in reputation-destroying approaches.
    How dare these possibly well-meaning but obviously not-competent-for-the-job people interfere with our work as health practitioners serving the Australian population? At the very least they should indemnify properly anybody coming to harm from their careless chaotic approach.
    If a competent person would realise that they cannot do their work properly with the available resources, they have a professional obligation to simply call it quits until the impasse is resolved. We are talking after a mere bureaucratic institution after all, not about somebody who has to improvise on the spot under time pressure in an emergency situation as many of us doctors often have to do.

  4. Anonymous says:

    My experiences with AHPRA registration mirror the many posts already made (eg my telephone number had 16 digits amongst several other mistakes). Attempts to correct these errors by email, mail or through the sympathetic Irishman on the phone proved unsuccessful and eventually electronic registration worked with the incorrect phone number and other details still in place. Letters to Dr Flynn pointing out my frustration have gone unanswered, which was also the case when she headed the Victorian Medical Board. They hold us accountable for every move we make. Who holds them accountable? Certainly not the politicians who have created the system and presumably got what they set out to do – further demoralise and demonise the medical profession.

  5. Anonymous says:

    I am an Australian-born tertiary-trained specialist. Prior to AHPRA, I had unconditional registation in several states. Following AHPRAs takeover of registration, I had conditions placed against my national regstration claiming that I required supervision to prescribe medication. This had no basis in fact. Medical recruitment staff at various hospitals took the details on the AHPRA website as gospel. I was denied employment contracts as a result. I am now suing AHPRA for loss of income and defamation.
    For every ‘Jayant Patel’ in Australia, countless other honest, qualified, conscientious clinicians have been prevented from delivering timely essential health care to sick Australians.
    I believe we should take a class action.
    It is very sad that as doctors we have allowed our profession to deteriorate to the level of a 3rd world beauracracy.
    Now there is a highly-racist cast system, no more obvious than in Queensland, where uneducated caucasian Australians, who are employed in “health care management”, persecute and abuse coloured doctors of foreign origin, and they are paid for doing so, in the name of better health care.
    The public and the government are entirely ignorant of this.
    It is time for all of us to wake up and take action.
    It is tragic for sick patients if doctors now lack any degree of social conscience, or orgaisational skills, to stand up for essential social values.
    The only alternatve, morally speaking, is to take a class legal action, or failing that, to leave the profession en-masse and give the job to all these beauracrats who believe they know something about health care.
    They are resposible for morbidity and death of literally hundreds of Australians each year, and we are letting them do it.

  6. Bruce Connor says:

    What concerns me greatly is that All Doctors on retirement from Practice will under this new AHPRA be denied all medical rights and entitlements ie not even script writing or referals for oneself or family.Nor will they be able to do voluntary work or overseas charity work as they will be unregistered. This is Draconian.This should not be accepted and should be challenged. Bruce Connor FRACP FACD

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