Medical Board of Australia - Leading, directing and managing

Leading, directing and managing

Management and organisational structure

Agency Management Committee

The Agency Management Committee, Ahpra's governing body, meets up to 11 times per year. The Committee publishes a communiqué of meetings that summarises issues discussed and decisions made. It has established four committees:

  • Finance, Audit and Risk Management Committee
  • Regulatory Performance Committee
  • People and Remuneration Committee
  • Accreditation Advisory Committee 

National Executive

The National Executive is Ahpra’s national leadership group.

Directorates

Ahpra has five directorates:

  • Regulatory Operations 
  • Strategy and Policy
  • People and Culture
  • Finance and Risk
  • Information Technology 

State and territory managers

Our state and territory managers are our senior leaders in each jurisdiction, and are based at each of our offices.

Ahpra and the National Boards work in partnership to deliver financial performance. The financial statements section of this report describes the performance in more detail, including the net result and equity position for each National Board.

Financial overview

Both total income and expenses from transactions have steadily increased since 2016/17. The fluctuation in the net result for each period reflects growing business operations to support the scheme and phasing of investment in technology programs. The overall net result of $17.3 million in 2020/21 is an increase from $6.7 million in 2019/20.

Fluctuations in net cash flows reflect the timing and any changes in registration renewals, employee and vendor payments and operating results. 

Financial performance

The National Scheme income for the full financial year to 30 June was $235.2 million, an increase of $14.8 million from 2019/20. The growth was due to an increase in registration income and government grants. Fees are set for each National Board to meet the full costs of regulation for each profession. Five National Boards froze their registration renewal fees, eight Boards increased their fees by 2.5% or 3.0%, and two Boards reduced them. 

Grant funding from the Commonwealth Department of Health provided $4.6 million in support to Ahpra and National Boards to increase the number of health practitioners registered and available to work in the health system in response to COVID-19.

Total expenses from transactions were $217.8 million, an increase of $4.0 million from 2019/20. The higher net result realised this year was due to increased income and reductions in expenditure from the impact of COVID-19 on business as usual and project delivery, offset by enterprise agreement wage increases, additional resource and technology costs of business continuity and the response to increase Australia’s health workforce capacity. 

Financial position

The balance sheet remains healthy at 30 June 2021, with the largest contributor to this being both cash and term deposits held that includes $109.5 million registration fees paid in advance. Overall net assets (equity) increased by $17.3 million to $86.9 million.

The financial statements provide disclosure of income and expenditure by each National Board for the year and the equity balances held at year end. The amounts held are assessed against equity targets, based on independently developed actuarial models.

Equity serves several important purposes, including: 

  • mitigating against unexpected loss not covered by the National Scheme’s comprehensive insurance 
  • funding capital and strategic projects that support the effective and efficient operation of Boards and the Scheme
  • offsetting the impact to the financial position due to variance in the operating result.

The equity balance at June 2021 includes funding for strategic projects that were deferred by 12 to 24 months due to restrictions or other consequences of COVID-19. These projects have been committed to by Boards and the Scheme to support effective and efficient operation. 

Assets

Current assets increased by $53.5 million to $137.0 million in 2021, largely offset by the $27.5 million reduction in long-term investments and the $8.7 million consumption of right-of-use property lease assets. As term deposit rates decline, a change to investment policy is being considered and we made more short-term investments to ensure funds can be readily accessed at maturity for transition to new types of investments, which will be beneficial to realise early improvement to return on assets. 

Capital expenditure

Capital expenditure was below anticipated levels with several approved projects being delayed. IT capital projects were delayed as the team prioritised requirements for work from home, implementation of the second stage of the IT restructure and adjustment to the lead-in phase of our transformation program. 

Liabilities

The significant increase in employee benefits provisions arises from business growth, maturity in years of service, wage inflation and economic revaluation of long service leave and lower than accrued levels of annual leave taken due to pandemic restrictions.

The year ahead

We expect the overall financial performance in 2021/22 to be a smaller operating surplus, then to stabilise over the coming years consistent with our five-year financial plan.

Risk management

Ahpra’s Corporate assurance framework aims to provide sufficient, continuous and reliable assurance on the management of major risks to continuously improve regulatory services to the Australian community. Ahpra, in partnership with National Boards, seeks to manage risks in ways that allow us to meet the objectives of the National Scheme Strategy.

During 2020/21, the National Scheme managed its risks within the following risk themes:

  • Regulatory performance
  • Business transformation, continuity and resilience
  • Improving the health of Aboriginal and Torres Strait Islander Peoples and protecting all vulnerable communities 
  • Financial sustainability
  • Public confidence/trust
  • Data governance
  • People and culture
  • Health practitioner workforce sustainability. 

Risks are managed in accordance with the Australian and New Zealand Standard (AS/NZS ISO 31000:2018) and the risk management processes are an element of Ahpra’s Corporate assurance framework. The corporate assurance and risk management processes are integrated with the strategic and business planning processes and come from many sources within the organisation.

Insurance policies are in place to adequately mitigate the risk of financial losses arising from an (insured) event. 

Corporate legal compliance

In addition to regular reporting to Finance, Audit and Risk Management Committee (FARMC), we have undertaken the following tasks to improve governance and compliance:

  • a review of Ahpra’s Procedure to respond to a breach of privacy in consultation with the National Health Practitioner Ombudsman (NHPO) to ensure it reflects best practice and encourages open reporting of privacy breaches by staff
  • a review and re-draft of Ahpra’s Privacy policy to implement recommendations made by the NHPO in its Review of confidentiality safeguards for people making notifications about health practitioners December 2019 report
  • amendment of Ahpra’s Fraud and corruption control framework to include clear reference to ethical issues and community expectations, and to clarify the interaction between the framework and Ahpra’s Public interest disclosure policy
  • starting the roll-out of an Ahpra-wide legislative compliance program using existing technology to automate reporting.

Ahpra’s Public interest disclosure policy is for the use of Ahpra staff as well as members of the public. Nine referrals were received by Ahpra’s whistleblower hotline provider, Deloitte. After an assessment, none of these referrals were found to meet the criteria of public interest disclosures. No matters were referred to the Independent Broad-based Anti-corruption Commission IBAC (Vic) or Independent Commissioner Against Corruption ICAC (NT).

When – and why – people complain about us 

Ahpra aims to listen to the concerns that people raise, respond to complaints promptly, empathetically and fairly, and to learn from the issues raised. 

Administrative complaints relate to concerns about the service delivery, policies, procedures and decisions of Ahpra, National Boards and Committees, and the Agency Management Committee. 

Straightforward complaints (stage 1) are handled by the Ahpra area that receives them, and complex complaints (stage 2) are managed by a National Complaints team. Stage 3 complaints are investigated or reviewed externally by the National Health Practitioner Ombudsman (NHPO). 

We have improved the information we collect about complaints. This year’s increase in the number of complaints received is attributed to:

  • implementing online submission of complaints in July 2020, which has made it easier for people to make a complaint
  • reporting stage 1 complaints that are submitted online; previously these were not included.

Most complaints – 536 – were received from health practitioners. People who had made a notification about a health practitioner made 149 complaints. Ahpra also received 48 complaints made as a result of public campaigns encouraging people to raise an issue with Ahpra. We received public campaign complaints about statements made by Ahpra and the National Boards in support of the COVID-19 vaccination program and about regulatory action taken about specific health practitioners.

We received 812 complaints by profession, with 892 issues raised.

Registration complaints - top 4 issues

In the 445 complaints received about registration, perceived delay in our management of applications was raised 174 times, policies or processes 118 times, communication 87 times, and the outcome 65 times.

Notification complaints - top 4 issues

In the 332 complaints received about notifications, dissatisfaction with the outcome was raised 218 times, communication 56 times, policies or processes 49 times, and the time taken to finalise a notification 48 times.

Resolving complaints

We responded to 798 complaints. When we receive a complaint, we carefully review the information provided and how people would like their complaint resolved. We then conduct a review of the information we hold and endeavour to respond in a way that meaningfully addresses the concerns raised. 

Performance

We aim to respond to complaints within 20 business days. Figure 90 shows that our average time to respond was consistently below the expected timeframes.

Engaging with the NHPO

The NHPO receives complaints and helps people who think they may have been treated unfairly in administrative processes by the national agencies in the National Scheme. We engage collaboratively with the NHPO to resolve complaints and value its contribution.

Under our early resolution transfer process with the NHPO, 143 complaints were handed to us to resolve directly.

We responded to 81 enquiries received from the NHPO seeking preliminary information about a complaint. We also provided documents and other information in response to 96 notices of investigation from the NHPO. 

A complaint can be reported more than once if a person complains to both Ahpra and the NHPO.

Ahpra received:

  • 204 valid applications for access to documents under the Freedom of Information Act 1982 (FOI Act)
  • 13 applications for internal review of an FOI decision.

The National Health Practitioner Privacy Commissioner (NHPPC) notified Ahpra that:

  • 9 applications for external review of an Ahpra FOI decision had been made
  • 7 external reviews had been closed because they were withdrawn. 

The NHPPC provided notice that Ahpra’s FOI decision had been affirmed in three matters. In another two matters, the NHPPC notified Ahpra that a decision about not releasing documents was being upheld, but that the reasons for withholding access had been varied. Ahpra was advised that five applicants had withdrawn their applications for external review.

During the year, 248 FOI applications were finalised. Outcomes are shown in Table 45. At 30 June, 42 FOI matters were open and had not been finalised.

Evidentiary certificates

Ahpra issued 155 evidentiary certificates, most in response to requests from our co-regulatory partners, health complaints entities and police, to help them to perform their functions in the community.

Production of documents

We responded to 105 subpoenas and orders to produce documents issued by courts, tribunals and law enforcement bodies about proceedings in which neither Ahpra nor a National Board was a party. 

 
 
 
 
Page reviewed 22/11/2021