Doctors often feel guilty until proven innocent under AHPRA, the association argues.
The Australian Medical Association has put in a scathing submission to the National Health Practitioner Ombudsman’s review of AHPRA, saying it was “appalled” by some examples of immediate action.
These included cases that stretched on for months or years – at least one case has been open since 2017 – with some doctors resorting to driving for rideshare services to make ends meet.
“Immediate action is one of the strongest sanctions available to AHPRA allowing it to immediately suspend a practitioner or impose conditions after allegations have been made, but before any wrongdoing is proven,” AMA president Dr Danielle McMullen said.
“Such an action implies guilt before innocence can be proven, and can inflict irreparable damage to a practitioner’s reputation, derailing their career and their relationships with patients, colleagues, and employers.”
One doctor, it said, had been informed via phone that they were subject to an immediate action but were not given any reason until their medical defence organisation followed up with AHPRA several days later.
Another was given two weeks to find a lawyer and prepare to testify, only to be met with no communication from AHPRA for close to a year.
The NHPO review itself is looking at how matters involving registered health practitioners who were subject to immediate action – i.e. were suspended from practicing or had significant conditions placed on their registration before an official finding was made – were handled with procedural fairness.
According to the AMA, there are two fundamental problems with the regulator’s immediate action powers.
The first of these is that that AHPRA is allowed to take action too lightly and the second is that it takes too long to finalise investigations.
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There was a significant double standard in that while doctors and insurers were often given rapid deadlines to provide evidence and lodge appeals, AHPRA is held to no such timeline.
Addressing these issues, in the association’s eyes, would require amending section 156 of the Health Practitioner Regulation National Law to make it clear that immediate actions should only be used in extreme circumstances, adding a subclause to section 158 requiring the relevant national board to present to the ombudsman to justify taking immediate action and mandating that AHPRA has a duty of care to registrants.
On this last point, the AMA said the regulator would specifically be obliged to minimise the mental health impacts and financial effect on the practitioner subject to a notification.
“The [relevant national] Board has an ongoing obligation to the practitioner,” the AMA submission read.
“It must be in the Board’s interest to resolve the case as soon as possible, and practitioners must have a path to legal redress if they are victim to the unfair application of the power.”
Right now, it argued, there is simply no incentive for AHPRA to close an investigation.
“Part of the issue is once the Board has made its decision, it has little ongoing involvement and no incentive to ensure AHPRA resolves matters in an appropriate timeframe,” the AMA said.
“[Among countries with similar regulatory regimes] … Australia is alone … in not having a time limit for these actions.”
Both the RACGP and medical indemnity organisation Avant Mutual have put in similarly critical submissions to the review.
Like the AMA, Avant also recommended a mandatory timeframe for investigations following immediate actions be embedded in the law.
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