Doctor groups are unconvinced by the regulator’s assurances that they are necessary or fair.
Proposed new powers to make public statements about doctors under investigation will be used only sparingly, AHPRA said last week in an attempt to allay practitioners’ concerns.
At a public hearing last week the AMA blasted the proposal, arguing that the regulator’s new “main principle” of public protection and maintaining public confidence in the health system allowed mischaracterisation of the services that doctors provide.
“The new main principle appears to suggest we can provide health services in a way that is completely risk-free and that we would always choose a lower-risk procedure,” AMA president Dr Omar Khorshid told the hearing.
“We do not support this view. We must support patients’ choices, even where it may be in making decisions that we would not recommend they make, such as having a natural delivery even though we recommend a caesarean section, or a patient’s decision to participate in a clinical trial for an untested new treatment.
“There is a lot of complexity and a lot of grey areas here.”
The comments were delivered at a Queensland government committee hearing last Wednesday to consider amendments to the health practitioner regulation National Law. The committee will make its recommendations by 1 July. The amendments have been signed off by health ministers and will next be considered by the Queensland parliament, the lead jurisdiction on the law.
AHPRA CEO Martin Fletcher countered, claiming that “at this early stage, I can see a narrow but important role for those powers in a small number of circumstances”.
He said the concerns of the AMA, RACGP and other doctors’ groups were valid, but argued these were best addressed by ensuring the proposed powers were handled within “strict parameters”.
“The bar needs to be both high and clear to all,” he said. “Practitioners rightly expect procedural fairness and natural justice in our regulatory work, and the bill includes significant checks and balances.
“We will also develop guidance on how we will use these powers in practice and consult widely with the professions and the community to get it right. We will publish this guidance to ensure full transparency.”
Dr Khorshid agreed that protection of the public was critical, but said this was already achieved under current arrangements.
The RACGP also opposes the proposal to allow information on complaints to be made public before investigations are complete.
“We need to make sure that the proposed amendments of the Bill strike a good balance and ensure both medical practitioners and the public have confidence in the regulatory system,” RACGP president Adjunct Professor Karen Price said.
In the past few days, media coverage of cosmetic surgery and the industry’s regulation – including the role of patient testimonials – has occupied centre stage.
Dr Khorshid said the proposal to allow doctors to use testimonials was “bizarre” and ill thought out, partly thanks to the way the pandemic had disrupted the development of the amendments.
“There are a lot of amendments contained in this bill which have far-reaching ramifications for the medical profession and for our patients,” he said.
“It was largely constructed during the height of the pandemic. This meant that the consultation process, in our view, has been well less than satisfactory. Many of the changes have not been thought through.
“I think the best illustration of that is this bizarre proposal to remove the current ban on patient testimonials from advertising material.”
AHPRA is currently conducting a review of the cosmetic surgery industry, which was sparked by a joint investigation by the ABC’s Four Corners and Nine newspapers. However, the agency does not expect to publish the review findings and recommendations until September – long after the National Law amendments inquiry wraps up.
