Australia’s health ministers broadly agree on NRAS changes, but major structural questions remain unresolved.
Health ministers have endorsed a broad package of reforms to Australia’s health practitioner regulation system following a major independent review but have stopped short of adopting some of the most significant proposed structural changes.
In a communique released after the 1 May Health Ministers Meeting, governments outlined their response to the review of complexity in the National Registration and Accreditation Scheme, accepting many recommendations while deferring or rejecting others.
Ministers agreed to strengthen oversight, improve complaints handling and refine governance arrangements but left key questions around national consistency and regulation of lower-risk professions unresolved.
Complaints system reforms
The complexity review made seven recommendations under the “unified national approach to health complaints/improved management of high-risk matters” banner, four of which were accepted in full.
These comprised recommendations forcing AHPRA to “immediately improve timeliness and quality of investigation processes and decision making and the availability of clinical advice across all regulatory functions”, implement a complaints navigator service, consider the need for additional education to ensure practitioners are up to speed on professional standards and research and report on outcomes of significant tribunal decisions.
The two recommendations accepted in part included actions asking the regulator to seek advice from the Health Workforce Legislation Committee about amendments needed to establish a statutory right of review of notification decisions for notifiers, as well as look into creating an independent director of proceedings role and harmonising health practitioner tribunal rules.
However, the ministers rejected a key recommendation to establish a unified national entry point for complaints, instead opting for further work to “identify opportunities for collaboration to streamline complaints handling” and consider a “‘no wrong door’ approach to management of complaints”.
The decision effectively maintains the status quo, where complaints can be handled by multiple bodies across jurisdictions.
Governance overhaul
Ministers agreed to a stronger national stewardship model for practitioner regulation, including the development of a “ministerial council statement of expectations of the national scheme … issued to the AHPRA board” and renewed every two years.
They also backed structural changes within AHPRA, including transitioning the agency board to become the “National Scheme Board” and introducing new governance and leadership arrangements.
The communique emphasised a need for improved coordination and accountability, noting that regulator collaboration should support “a proactive and holistic approach to regulation” while remaining “agile and flexible with a problem-solving focus”.
Unregistered practitioners and regulatory gaps
Ministers also moved to strengthen oversight of non-registered practitioners, committing to complete implementation of the National Code of Conduct and supporting, in principle, the creation of a “national register of prohibition orders”.
However, the communique made clear that the register remains contingent on further work, with development “accepted in principle pending further advice on hosting and funding arrangements”.
Key reforms deferred or diluted
While most of the recommendations of the review were accepted, several of the more ambitious proposals were either rejected or deferred.
A proposed integrated national framework for regulating all health professions, including new models for lower-risk occupations, was deferred pending further work on alternative approaches.
Ministers also rejected an immediate process to expand the National Scheme to additional professions, noting that work on a revised risk assessment framework was due to be completed in mid-2026.
Related
In addition, a proposal to establish a large national health workforce “strategy assembly” was not accepted, with ministers arguing such a forum would be “unlikely to adequately capture the breadth of different perspectives”.
A cautious reform path
Across the communique, many actions were described as “accepted in part” or deferred to future work, signalling a cautious approach to reform.
Ministers acknowledged the “health system is complex with diverse stakeholders” and that reforms must avoid adding administrative burden or duplicating existing structures.
For its part, AHPRA said it was working constructively with the Health Workforce Taskforce.
“Ahpra welcomes the final response from Health Ministers to the Independent review of complexity in the National Registration and Accreditation Scheme,” it told The Medical Republic.
“Ahpra’s new five-year strategy, together with reform work already underway, are deeply aligned with the decisions by Health Ministers.”
