From the CEO: Mandatory reporting – looking to the future

While 2017 has been a year of big issues, without a doubt one of the biggest issues has been mandatory reporting. The AMA, along with many other groups have correctly identified mandatory reporting as one of the key barriers to doctors getting help for their health conditions. The problem is both the legislation itself and more significantly, the perceptions of the legislation and the potential for reporting to the Medical Council.

Mandatory reporting has always been controversial and this controversy has sadly taken away from some very important facts about the issue. In light of the current dramas, I thought it was worth revisiting some of those facts.
Mandatory reporting arose during the short-lived ministerial term of Reba Meagher. It was in direct response to the daily media hysteria around Graeme Reeves, the obstetrician and gynaecologist subsequently convicted in relation to his patient care. Mr Reeves – also known very unfairly as the Butcher of Bega – was headline news. Like all headline news, the truth of the issue (including that Mr Reeves spent very little time practicing in Bega) was lost in the drama.

At the same time, we were battling with the proposed changes to the registration of health practitioners as part of the move to the national registration of doctors. For reasons which turned out to be very wise, AMA (NSW) had significant concerns about the impact of national registration for doctors. We feared that the scheme would be expensive, bureaucratic and would undermine the role of doctors in regulating the profession. At the time, we were working with the NSW Government on whether NSW could hold out from the strong momentum of this scheme – a scheme which was being portrayed by politicians across the land as the basis upon which patients would be protected from the Graeme Reeves of the world.

By working with the Government, we drafted mandatory reporting legislation which made no mention of impairment – for treating doctors or for any other doctors. This was because we could see that no doctor should need to report impairment where they were managing that impairment effectively. The legislation was also drafted in the present tense – that is it focused on current and immediate risk, not past risk.

Unfortunately, this approach was not adopted in Queensland and then was not included in the national law. The national law creates a direct obligation to report impairment and also potentially requires the reporting of past behaviour (subject to assessment of risk). These are things we need to change because they are impacting on the trust doctors have in getting care. We know change won’t be easy – for every struggling doctor, there is a bad news story which also hits the headlines. However, we are pleased to see the commitment to start towards a change – returning to the situation in which impairment was not a relevant factor would be a good start.