National registration and accreditation for the health professions

Change is afoot in health professional regulation. 2010 will see the introduction of the first national registration and accreditation scheme for health professionals. This article addresses who will be covered and the likely impact on the registered professions. The next edition of the newsletter will include the HSU’s assessment of progress toward implementation and the emerging opportunities and challenges for members.

Accreditation of health professional courses is included in the scheme and the HSU did comment on aspects of the accreditation arrangements in its July submission. However, we are focusing our efforts on the registration aspect of the scheme as this will have the most direct impact on members. The scheme is hereafter referred to as only national registration.

Table one lists the professions to be included in the scheme and the date from which they will be included.

Table 1: National registration, professions and timing
Professions that will be registered nationally at 1 July 2010
chiropractors
dentists (including dentists, dental therapists, dental hygienists and dental prosthetists)
doctors
nurses
optometrists
osteopaths
pharmacists
physiotherapists
podiatrists
psychologists

Professions that will be registered nationally at 1 July 2012
medical radiation practitioners
Aboriginal health workers
occupational therapists
Chinese medicine practitioners

Boards have already been established for each profession that will be included in 2010. The Chairs of relevant boards are:

• Dr John Lockwood, Chair, Dental Board of Australia

• Mr Stephen Marty, Chair, Pharmacy Board of Australia

• Mr Glenn Ruscoe, Chair, Physiotherapy Board of Australia

• Mr Jason Warnock, Chair, Podiatry Board of Australia

• Associate Professor Brin Grenyer, Chair, Psychology Board of Australia

The final bill to enact the scheme has not been released so comments in this article are based on a Ministerial Communiqué issued in response to submissions received on the draft bill. The HSU is pleased to announce that some of the key concerns raided in its submission have been addressed in the communiqué.

The most complex and flawed sections of the draft Bill related to the introduction of a Public Interest Assessor. The proposal would have introduced an additional level of bureaucracy and made the complaints management process less transparent for consumers and clinicians alike. The HSU strongly argued against this proposal and the recent communiqué announced that the proposal has been withdrawn.

The draft Bill proposed mandatory reporting of practitioners for 'reportable conduct'. Peers, colleagues and employers would be required to report any registered clinician who:

• Practiced while drunk or drug effected

• Engaged in sexual misconduct in connection with practice of the profession

• Placed the public at risk of harm because of impairment or

• Placed the public at risk because of an unacceptable standard of practice.

The Union argued that mandatory reporting may be used punitively by employers and that instead of mandatory reporting, an environment should be created wherein professionals are confident to report colleagues in the knowledge that they will be supported and assisted to overcome their problems or deficiencies. This would include health programs and counselling to support underperforming practitioners. These matters will be raised with the relevant national boards.

Criminal history checks were also opposed on the grounds of the costs they would impose on registrants, that the type of check proposed could unearth spent convictions and charges which could unjustly influence registration decisions. Also, checks would achieve nothing. There is no evidence that a Jayant Patel would have been picked up on an Australian check, so what use can they be?

Ministers seem to have taken some account of the Union's submission, in that the communiqué says:

"Ministers noted comments that there were insufficient requirements around the way the new national boards would treat information received through criminal history checks. As a result, Ministers agreed that the legislation should be amended to require boards to take into account only those matters relevant to the purposes of registration. In addition, boards would be required to include in their registration standards for Ministerial approval a statement of how relevance is to be assessed."

The HSU will be approaching boards to discuss the scope of 'matters relevant to the purpose of registration'.

The Union did not oppose CPD but argued that legislation must ensure that a broad range of activities are accredited toward CPD compliance. Requirements to participate in a program delivered by a single organisation is anti-competitive and an unfair restraint of trade. Again, the Union will be raising these matters with relevant Boards.

Boards will consult on the following during October-November 09:

• professional development

• professional indemnity insurance

• criminal history

• English language skills

• previous practice

• Some boards will also be consulting on proposals relating to specialist registration, endorsements of registration and other matters identified by particular boards.

The HSU will be engaging with boards and we are very keen to receive input from members. You may provide input by replying to this message and including "national registration" in the subject line. Specifically, we are keen to hear your thoughts on how boards should manage mandatory continuing professional development, any concerns you may have about mandatory reporting and what offences you consider should be considered when a board is determining whether to register a health professional. Your thoughts on any other matter are welcome. Table two outlines the expected time frames. Due to the short timeline members are encouraged to provide input as soon as possible.

Table 2: Expected timeline leading up to National registration
Expected introduction of Bill B to QLD Parliament October 09
Consultation by boards Oct-Nov 09
Expected introduction Bill B other Parliaments Dec 09-Mar 10
Expected draft of Bill C Perhaps by December 09
Introduction Bill C to state/territory Parliaments Autumn 10

Let us know what you think. Send an email to info@hsu.net.au or send us a fax on 03 9341 3329. Don't forget to put "National Registration" in the title.

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