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