The modern definition of a ‘star chamber’ is any legal or administrative process that considers evidence without rules, gives weight to opinions it prefers, and presumes guilt. Sound familiar?
On 23 April 2025, approximately 200 health professionals gave up their precious Saturday to share their experiences of AHPRA and the Medical Board of Australia, and offer some solutions to what has become the modern iteration of a Star Chamber.
The 15th to mid-17th century English court was known for its lack of rules of evidence, lack of jury trials, and its use by the monarchy to suppress dissent. The modern use refers to any legal or administrative process that considers evidence without rules, gives weight to opinions it prefers, and presumes guilt.
In AHPRA and the MBA’s case, this is compounded by the imposition of penalties before an investigation, let alone tribunal hearing, is complete. In focusing on individuals, these entities often seem utilised to deflect responsibility for medical mishap resulting from dysfunctional systems, on to individuals.
These deficiencies are compounded by the often extraordinarily lengthy time it takes AHPRA to conclude its investigations. This ensures the Sword of Damocles hangs for an unreasonably extended period over the heads of both the guilty and the innocent alike.
Since the time to completion of an investigation can sometimes be measured in years, AHPRA’s behaviour ensures the investigation is the punishment, regardless of the alleged transgression or the eventual outcome.
Join me as I explore a few of the experiences shared by participants (space does not permit a complete coverage), including the partner of one of at least 16 completed suicides carried out by doctors while under protracted investigation by AHPRA.
In doing so I will follow the Chatham House rules which allows participants in a meeting to use information discussed, but not reveal the identity of the speaker(s).
I believe this is essential as, if the experiences recounted are to be believed, the regulators can act with bias, and with a thus far from accurate belief that they will never be called to account.
The deceased doctor’s partner
A specialist (whom I’ll call Dr X) in a hospital surgical setting had disagreements with colleagues and medical administration, who subsequently submitted a complaint to AHPRA about the specialist’s surgical care. No patient complaint or confirmed harm was involved.
It had all the hallmarks of a vexatious, unmeritorious complaint submitted for reasons that were non-clinical. Nonetheless, presented with such juicy grist for the mill, the Star Chamber’s fine-grinding wheels slouched into its treacle-like action.
As part of AHPRA’s investigation, it obtained the opinion of an “expert” who did not practice in the same surgical specialty.
Despite actual experts in the field clarifying that the procedure used by Dr X minimised potential harm in the circumstances in which it was used, AHPRA decided to act on its preferred expert’s advice for reasons it has chosen to never clarify.
It eventually had conditions placed on Dr X that made it impossible to continue practicing while the investigation ground on interminably over subsequent years. The result was highly predictable.
Gradually deepening depression resulting from years of mental torture without apparent end led to completed suicide, leaving a traumatised partner and their children bereft.
And for what AHPRA/MBA? For what? Certainly not for the protection of the public, of which the partner and their children are a part.
In my opinion you’d have to be the CEO of AHPRA or chair of the MBA to not only have allowed such an outrage to occur unchecked, but to be so unmoved as to offer no apology, no compensation to the practitioner’s partner and children, and offer no structural reform to ensure the risk of similar future events was minimised.
It would be of interest to learn what a Coroner’s Court would conclude should this death be brought before it, as may yet happen.
The locum
A highly experienced doctor accepts the offer of a locum position at a relatively isolated regional hospital, on the proviso that they will have a junior doctor on hand to ensure adequate 24-hour coverage for patients. The doctor is assured by senior hospital administration that this will be so.
The hospital administration presumably assumed that once they had ensnared a doctor, the doctor couldn’t leave. More specifically, there was no doctor handover, no other doctor at all on-hand or reachable, inadequate experienced ward nurse coverage and a previously misdiagnosed Aboriginal inpatient now in need of transfer to an adequate facility.
The doctor also refused to accept a clearly unsafe patient transfer.
After struggling with the impossible, to provide adequate patient care and with an administration unresponsive to requests for the promised assistant, the doctor notified the administrators of their view that the hospital was unsafe, and lodged a complaint.
The hospital’s administration responded by making a retaliatory complaint, alleging patient “abandonment” by said doctor, but took no action to correct the staffing deficit.
Knowing AHPRA/MBA as many doctors do, you can guess the rest.
AHPRA dismissed the doctor’s complaint but lent their full inquisitorial force to the hospital administrators.
So much for patient and public safety as AHPRA’s primary goal.
The poacher turned gamekeeper
An investigator – not a doctor, because there are none of those on AHPRA’s investigation teams – departs their role and establishes a business guiding doctors on how to comply with AHPRA’s demands.
Yet, how can one be guided to comply with ever-expanding demands of a body infamous for weaponising vexatious/frivolous complaints, conducting biased, incompetent and malicious investigations slothfully, while ignoring legal principles of procedural fairness, freedom from bias, the presumption of innocence, and basic rules of evidence?
In this I am reminded of a previous injustice where anyone could complain or be complained against and if the accused were charged, they were presumed guilty. Officials could apply torture. There were no rules of evidence.
The auto-de-fé, the public condemnation of heretics was the final step of the Inquisition’s tribunals,involving the public punishment of those found guilty. Sound familiar?
We don’t need further “education” as to how to satisfy AHPRA/MBA. An auto-de-fé cannot be satisfied, except by the public punishment of heretics.
What we do need is structural reform and changes to the Health Practitioner Regulation National Law Act 2009 (the Act) to ensure AHPRA/MBA conducts its activities in a timely, competent, and unbiased manner. The problem does not lie at the individual practitioner’s feet, nor does the solution.
Reform
These indicative cases help clarify why AHPRA and the MBA fall short of meeting their stated goal of protecting the public, while concurrently scapegoating frontline health practitioners and their families.
In my opinion the following needs to be done to reverse this lamentable situation.
The core of the problem lies in the deficiencies of the Act that defines the powers of AHPRA.
That Act makes no provision for the presumption of innocence, for natural justice and procedural fairness, for a duty of care owed to either the complainant or the one being complained about, or for enforceable timeliness of investigations.
It also makes no provision for the sanction of those weaponising the complaints process when making vexatious, intimidatory or vindictive complaints, while at the same time encouraging them by allowing them to be made anonymously.
These deficits, long known and reported in repeat Senate inquiries, have resulted in no apparent action from members of the Ministerial Council which has the power to direct AHPRA and to recommend changes in applicable law.
Why?
Is it because an AHPRA that solely targets frontline individuals for what are often systemic resourcing failures, serves those politicians in much the same way as did the Star Chamber, by deflecting opprobrium to scapegoats?
I leave it to you dear colleagues to decide – and lobby accordingly.
Dr Michael Gliksman is a physician in private practice in Sydney and a past vice-president and chair of Council of the AMA (NSW), and a past federal AMA councillor. He has never been the subject of a patient complaint to any regulatory body.
