The national registration scheme for health professionals should be regarded as an expensive experiment that has partially failed, a review of the five-year-old scheme has found.
Published in the latest edition of Australian Health Review, analysis by Kerry Breen found that the system is not truly national (with NSW and Queensland opting for co-regulation) and has significant flaws.
Breen, a past president of the Australian Medical Council and the Medical Practitioners Board of Victoria, identifies several key drawbacks in the scheme:
- sudden marked increase in annual fee for registration renewal (~50% in some states)
- size of the new bureaucracy – problems of accountability and efficient access to information and advice eg important regulatory information about state-based laws around drugs and poisons
- remoteness from those it regulates
- one-size-fits-all policy framework – creating unnecessary delays in guideline approval
All of this has, anecdotally at least, translated into loss of trust in the regulator, says Breen.
He also notes major issues in the national law including sections regarding mandatory reporting of misconduct or impairment due to ill health, definition of ‘clinical practice’, and the issuing of cautions.
“The national scheme should be regarded as an expensive experiment that has partly failed,” he writes.
Breen finds little evidence in AHPRA’s reporting of identifiable benefits apart from greater ease of movement between jurisdictions for health professionals, increased opportunities for workforce and other research and enhanced protection of the community through unification of databases.
Breen says the NSW model of co-regulation now looks “very attractive”, bringing “the benefits of more accountability of the core aspects of the scheme to the state health minister, a less remote bureaucracy and restoration of trust”.
He says a “much pared-down AHPRA” ought to maintain the central database for national portable registration and calls for an accreditation system that is separate from the medical regulatory system, as recommended by the Productivity Commission.