31 Jul 2020
An independent report has found reforms of the regulatory management of allegations of sexual misconduct have had a profound impact.
The Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board of Australia (MBA) commissioned the author of the ground breaking 2017 Independent review of the use of chaperones to protect patients in Australia, Professor Ron Paterson, to assess what had been achieved and identify what more could be done to improve their handling of sexual misconduct allegations.
Professor Paterson, Professor of Law at the University of Auckland and Distinguished Visiting Fellow at Melbourne Law School, found that Ahpra and the MBA have fully implemented ‘nearly all’ his recommendations and made significant changes to regulatory practice.
‘My in-depth assessment of current practice is that the changes made by Ahpra and the MBA, in response to the chaperone review report, have been wide and deep,’ Professor Paterson said.
‘The impact … has been profound in terms of how notifications of alleged sexual abuse are dealt with by regulators. It is too early to say whether the changes will flow on to have a positive impact on patients and the public, but there are promising signs,’ he said.
The report notes the huge changes since 2017 to community and media discussion of sexual misconduct arising from the #Metoo movement and as a result of the Royal Commission into Institutional Responses to Child Sexual Abuse.
The report finds that the National Registration and Accreditation Scheme compares favourably with international health practitioner regulators on this issue, and is ‘highly advanced in how it operates in this complex and demanding area’.
Major changes to regulatory practice made by the MBA and Ahpra since 2017 to improve the handling of allegations of sexual boundary violations include:
Ahpra and the MBA have accepted all Professor Paterson’s recommendations to ensure continuous improvement, including by:
Professor Paterson’s report notes the ongoing use by tribunals of chaperones as a mechanism to protect the public, despite the recommendations of his initial report.
‘These decisions suggest that the thinking of tribunals about alleged sexual misconduct by health practitioners is still evolving and may not yet reflect changing community expectations,’ he writes.
Ahpra CEO, Martin Fletcher, welcomed Professor Paterson’s findings and said Ahpra was committed to continuous improvement.
‘Sexual boundary violations have a devastating impact on patients. We will keep doing what it takes to make our processes as sensitive, fair and efficient as we can,’ Mr Fletcher said.
Chair of the Medical Board of Australia and inaugural Chair of the Sexual Boundaries Notification Committee, Dr Anne Tonkin, said patients trust their doctors to care for them and do the right thing.
‘The vast majority of doctors in Australia justify that trust. When something goes wrong, patients deserve to be heard and respected in a sensitive and fair process that is designed to keep all patients safe and we are committed to providing that,’ Dr Tonkin said.
Highlights of Ahpra’s action plan to address Professor Paterson’s recommendations include:
Ahpra started the roll-out of a staff wellbeing and support program through 2019. Phase 2 of the program includes targeted support for staff at specific risk of vicarious trauma.
Ahpra staff and Committee members have access to a confidential 24-hour, seven days per week Employee Assistance Program, which offers counselling, emergency support and other services and resources.
Training for notifications staff is ongoing in relation to managing communication with distressed persons.
The MBA SBNC has demonstrated that a model involving highly specialised decision-makers leads to improved quality and consistency of decision-making.
Ahpra and National Boards will consider alternative committee arrangements to ensure highly specialised decision makers for sexual boundary cases across the scheme.