National Law – Fit for purpose?

The Australian Health Ministers’ Advisory Council (AHMAC) closed the consultation period on reforms to the National Law 31 October.

Federal AMA, along with AMA (NSW) and several other AMA State/Territory branches, prepared comprehensive submissions in response to the proposed changes to the Health Practitioner Regulation National Law.

BACKGROUND The National Law established the National Registration and Accreditation Scheme, which has been in operation since 2010. It’s delivered by 15 National Boards and supported by the Australian Health Practitioner Regulation Agency (AHPRA). The scheme is overseen by the Council of Australian Governments Health Council and regulates more than 700,000 health practitioners across the country.

An Independent Review of the National Registration and Accreditation Scheme (the NRAS Review) was conducted in 2014. Following that, health ministers launched a staged implementation in response to the review’s recommendations.

The first stage of amendments (Tranche 1) were made to the National Law in 2017. The Tranche 1 Amendment Act introduces national regulation of paramedics, as well as changes to strengthen complaints management, and AHPRA’s and the National Board’s disciplinary and enforcement powers.

Health ministers requested further reforms to the National Law in March 2017 relating to strengthened penalties and interim prohibition orders. Shortly after, in August 2017, health ministers requested advice on nationally-consistent mandatory reporting provisions under the National Law. An amendment Bill is currently underway.

AHMAC’s consultation paper was prepared and used as the basis for consultation for the next state of reforms (Tranche 2). The public consultation paper was made available mid-2018 and submissions closed 31 October.

The paper, “Regulation of Australia’s health professions: keeping the National Law up to date and fit for purpose”, posed 60 questions for review and proposed a number of controversial changes, including:

• Should a non-practitioner be able to serve in the role of board chairperson?
• Should the National Law require reporting of professional negligence settlements and judgements to the National Boards?
• Should the National Law (during preliminary assessment) empower practitioners and employers to provide patient and practitioner records when requested to do so by a National Board?
• Should the National Law be amended to empower a National Board/Australian Health Practitioner Regulation Agency (AHPRA) to issue a public statement or warning with respect to risks to the public identified in the course of exercising its regulatory powers under the National Law?
• Should the National Law be amended to restrict the use of the title “cosmetic surgeon”?
• Is the prohibition on testimonials still needed in the context of the internet and social media?

NSW is a co-regulatory jurisdiction, which means provisions in Part 8 of the consultation paper relating to “health, performance and conduct” of the National Law do not apply in NSW.

AMA supports a national registration and accreditation scheme that is fair to health practitioners and ensures a safe health workforce for Australians. However, there are a few proposals that have previously been identified by the AMA as issues of concern.

One such issue is the eligibility for appointment to chair a National Board. The consultation paper looked at whether the National Law should be amended to allow a community member to serve as chairperson of a National Board. The AMA has strongly argued that the chairperson must be a medical practitioner, on the basis that the role demands a level of expertise and specialist knowledge in the relevant profession. Chairpersons must also have the trust of the profession and the public.

To read Federal AMA’s full response to this proposal, you can find its submission at ama.com.au. AMA (NSW) will post its submission on changes to the National Law in the online version of this article at amansw.com.au.

WHAT’S NEXT?

The next step will be for the health ministers to consider the advice and recommendations arising from the consultation process during the first half of 2019, followed by a preparation of a draft amendment Bill if required in second half of 2019.