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I leave the Board this month after nearly 30 years in medical regulation, nine with the Medical Board of Australia and before that with the Medical Practitioners Board of Victoria. Over the years, I’ve spent a lot of time thinking and talking about medical regulation, what it’s for and how it works.
For me, it’s all about trust. Patients in Australia consistently report high levels of trust in their doctors, despite falling levels of trust in experts and institutions. They trust us to be competent, honest and reliable. As well, patients want us to care, to be compassionate and kind.
The best lesson for a doctor, or for anyone working in health, is to be a patient, or beside someone we love when they are sick. We feel vulnerable and powerless. Many of us in that situation, even the most articulate and health literate, have difficulty negotiating our complex health system and it’s not always clear to us that all members of the team are working together effectively. Even if they are, we wish they communicated better. The more vulnerable and powerless we are, the more we need to be able to rely on and trust our doctors.
Many things underpin this trust. There are professional standards and values, learned through medical education and training, reinforced by a strong professional culture of altruism and striving for excellence. Individual doctors and clinical teams monitor and regulate their own performance. In the workplace there are credentialing and clinical governance systems. The National Law establishes the statutory system of regulation to protect the health and safety of the public and gives the Medical Board and AHPRA functions and powers.
The work to establish the scheme is done and we are now facing new challenges. We are focused on engaging more strongly with the profession and the community, getting clearer about how we assess risk, improving the experience of notifiers and practitioners involved in complaints and evaluating our effectiveness in protecting patients. I believe that the scheme has the right basic architecture and the right strategy and that its greatest strength are the people who serve on Boards and committees and who work for AHPRA.
Martin Fletcher, AHPRA’s CEO, and his senior leadership team are very open, collaborative and responsive. Members of Medical Board committees around Australia come together to make decisions about individual practitioners, by applying the Board’s standards to individual cases and deciding what is in the best interests of the community. I would like to thank them all for their generosity, good will and commitment.
I particularly acknowledge my colleagues who are also retiring from the Medical Board, Professor Belinda Bennett, Associate Professor Stephen Bradshaw AM, Ms Prudence Ford and Dr Fiona Joske, all four of whom have worked incredibly hard to ensure that the trust that the Australian community places in doctors is well founded.
Appointments to the Board are made by Australia’s health ministers, the COAG Health Council. The new appointments have not yet been announced.
Every day across Australia, good doctors provide high quality care to their patients. They work hard, often in challenging circumstances, and do their best. In the years ahead, doctors will continue to make their patients their first concern, just as regulators will strive to shape an environment that keeps patients safe. It has been a privilege to have been involved in medical regulation for so many years and I would like to thank everyone who has been part of that work.
Dr Joanna Flynn AM Chair, Medical Board of Australia
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You can now apply online to renew your medical registration for another year. If you have provided AHPRA with your email address, we have emailed your first reminder to renew.
The registration fee for medical practitioners for 2018/19 is $764. The fee schedule is available on the fees page.
A video and tips for renewing online are available for medical practitioners on the registration renewal page.
Registration renewal for medical practitioners with general, specialist and non-practising registration is due by 30 September 2018. Renewal applications received during October will incur a late payment fee.
By law, all practitioners who apply to renew on time are able to practise while their annual renewal application is being processed. If you apply to renew on time or during the late renewal period, you can still practise medicine even if:
If your name appears on the national register, this confirms that you are registered even if the registration expiry date displayed has passed.
We understand that this can be confusing. If an employer or a member of the public wants to confirm that you are registered, they can also telephone us on 1300 419 495.
A practitioner who does not apply to renew their registration by the end of the late renewal period must be removed from the register of medical practitioners. Their registration will lapse and they will not be able to practise medicine in Australia. A ‘fast-track’ application can be made, but the practitioner cannot practise until it is processed and the national register is updated, which can take time.
We were really pleased to hear from more than 800 people and organisations who gave us feedback on proposed changes to Good medical practice: a code of conduct for doctors in Australia. We extended the consultation period for two weeks during August, to give more people an opportunity to participate.
Some of your feedback showed us that we need to express what we mean much more clearly, to prevent misunderstanding. Other comments highlighted the strength and variety of opinions held about some of the guidance in the code. The Board will be reviewing all submissions carefully in the months ahead, and making changes that support good medical practice in Australia.
Some of the sections in the code that triggered very active discussion in the community and the profession and were the focus of significant feedback included guidance on:
It will take some time for the Board to review all submissions and then finalise Good medical practice: a code of conduct for doctors in Australia. We will keep you informed as we continue this important work.
In the meantime, the current (2014) version of Good medical practice applies and is available on the Board's website. Previous versions have been in place since 2009.
We will also be publishing all submissions except when confidentiality was requested.
Do interns feel ready for practice when they graduate from medical school? What can we all do better to smooth the transition from university to internship for young doctors?
The Australian Medical Council (AMC) and the Medical Board have partnered to conduct a survey of all interns in Australia, to find out how well they think their medical training prepared them for their internship. This is the second year we have run the survey.
The survey is online, voluntary and anonymous. De-identified and aggregated data will be shared with medical schools and standards organisations, to shape future training improvements, and will also be published on the AMC and the Board websites.
AHPRA, on behalf of the Board, is sending the survey link to all interns and the AMC will analyse the responses. Interns recently received an email from the Board with information and a link to the survey.
If you are an intern:
If you work with interns, please encourage them to do the survey.
The survey will close on Monday 17 September 2018.
For more information read the news item on the Board's website.
Working with our stakeholders, we are progressing work on a National Training Survey (NTS), to better understand the quality of medical training in Australia.
Next steps include refining and consulting on the survey questions, appointing an independent provider to conduct the survey, house and analyse the data; and planning on how we will communicate the findings from the NTS.
We are addressing a range of issues as we develop the NTS, including data security, confidentiality, reporting requirements, participation rates and timing. We will be seeking advice from doctors in training, employers and supervisors to make sure the questions are clear, straightforward and will provide useful information to strengthen and improve medical training in Australia.
Read our progress update on the NTS on the Board’s website.
Send us an email to [email protected] if you would like more information or are interested in helping us develop the NTS.
All registered health practitioners inform AHPRA and their National Board about their principal place of practice. Sometimes, AHPRA needs more information about all the places a practitioner practises and will issue a ‘practice information notice’ to find out. This usually happens after a complaint has been made and the Board is considering what kind of support or supervision is available in different practice locations. Any restrictions imposed on a practitioner’s registration to protect the public need to be workable and accurately reflect their practice context.
AHPRA has published a new guideline that applies to all registered health practitioners, which makes clear what information you need to provide in response to a practice information notice, issued under s132 of the National Law.
The guideline was developed after broad public consultation and is available on the Board’s website.
Australia’s Health Ministers are consulting on some proposed reforms to the National Law1, which provides the framework for health practitioner regulation in Australia.
The Australian Health Ministers’ Advisory Council (AHMAC) is leading the consultation, in the second stage of the reform process. The first amendments in The Health Practitioner Regulation National Law and Other Legislation Amendment Act 2017 have already been made and are now being implemented.
More information about the reform process, a summary of the proposed changes and the consultation paper ‘Regulation of Australia’s health professions: keeping the National Law up to date and fit for purpose’ is available on the COAG Health Council website.
Submissions can be sent to [email protected]. The consultation closes Wednesday 31 October 2018.
1 The Health Practitioner Regulation National Law, as in force in each state and territory.
The Victorian Department of Health and Human Services has changed the prescribed notifiable conditions listed in the Victorian Public Health and Wellbeing Regulations.
Under the regulations, medical practitioners and laboratories in a range of settings ̶ including public and private hospitals, primary and community health, private practice and commercial pathology services ̶ are required to notify specific cases of infectious disease and other medical conditions to the department. The changes aim to streamline reporting, which allows the department to control public health risks, minimise the spread of disease and monitor disease patterns.
From 1 September, ten conditions will no longer need to be notified by medical practitioners. Notifiable conditions will also be grouped as urgent and routine, replacing the previous system of groups A, B, C, D. Under the changes, medical practitioners will no longer be required to provide written follow up for ‘urgent’ (formerly ‘Group A’) conditions. Pathology services will still be required to provide written notification for all conditions.
The new regulations start on 1 September 2018 and follow a consultation process held in 2017. Full details on the changes are available on the Victorian health department website.
AHPRA made this media statement last month:
‘Having your registration cancelled means you cannot claim to be registered’ says AHPRA as regulators win conviction — AHPRA has successfully prosecuted a former psychologist for claiming to be a registered psychologist and specialist medical practitioner when he is no longer registered as a psychologist and had never completed a medical degree.
There are important lessons for registered medical practitioners from tribunal decisions. The Medical Board of Australia refers the most serious concerns about medical practitioners to tribunals in each state and territory. There were no new cases published this month, but you can still access past cases.
AHPRA, on behalf of the 14 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.
When investigating a notification, the Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law1, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Practitioners’ names are not published, consistent with the National Law.
Summaries of tribunal and court cases are published on the Court and tribunal decisions page of the AHPRA website. The Board and AHPRA sometimes choose to not publish summaries, for example about cases involving practitioners with impairment.
In New South Wales and Queensland, different arrangements are in place. More information is available on AHPRA’s website on the Make a complaint page.
Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.
Comment on the Board newsletter is welcome and should be sent to [email protected].
For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).