The national registration scheme for health practitioners
In 2008, the Council of Australian Governments agreed to establish a national registration scheme for health practitioners by 1 July 2010. In July 2012, the scheme was amended to include four additional health professions, bringing the total number of professions covered under the scheme to 14. The scheme in NSW is governed by the Health Practitioner Regulation National Law (NSW) [National Law].
Under the National Registration Scheme, there are National Registration Boards for each of the health professions, including medical practitioners, nurses, and dental practitioners. All National Boards are administratively supported by the Australian Health Practitioner Regulation Agency (AHPRA).
In NSW, most National Boards have health professional Councils, which act in co-regulation with the Health Care Complaints Commission in relation to the handling of complaints about registered health practitioners.
How does the National Registration Scheme work?
A health practitioner registered in one state is also registered nationally and entitled to practise anywhere in Australia. Outside NSW, complaint management under the National Law provides for the relevant National Board to investigate and prosecute complaints before disciplinary bodies. Other than in NSW, there is no independent investigator or prosecutor.
The NSW complaints system
In NSW however, all complaints about health practitioners and health organisations will be notified to the Health Care Complaints Commission, even where the complaint is made to a Registration Board or Council. In NSW only, this includes mandatory notifications relating to a health practitioner practising in NSW. Mandatory notifications are deemed to be complaints in NSW and are automatically referred to the Health Care Complaints Commission to deal with.
Mandatory reporting of notifiable conduct applies to all registered health practitioners, as well as employers and education providers.
Under the National Law, all mandatory notifications must be made to the Australian Health Practitioner Regulation Agency (AHPRA). If they relate to a practitioner in NSW, AHPRA will forward them to the Commission.
The Health Care Complaints Act requires that in consultation with the relevant health professional Council, the Commission assesses how to most appropriately deal with a complaint. The Commission has a broad range of options, including alternative dispute resolution. Where there appears to be a serious issue of public health or safety, a significant question as to the appropriate care or treatment, or there appears to be gross negligence or grounds for disciplinary proceedings, the Commission must investigate the complaint.
Where the Commission investigation finds evidence that a registered health practitioner engaged in unsatisfactory professional conduct or professional misconduct, it will refer the complaint to its Director of Proceedings. The Director of Proceedings independently determines whether to prosecute the case and, if so, in which forum. Complaints about unsatisfactory professional conduct will usually be prosecuted before a Professional Standards Committee, while more serious complaints about professional misconduct will be heard the NSW Civil and Administrative Tribunal .
In NSW, unsatisfactory professional conduct is 'any conduct that demonstrates that the knowledge, skill or judgment possessed; or care exercised, by the practitioner in the practice of medicine is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience.'
Professional misconduct is defined as unsatisfactory professional conduct 'of a sufficiently serious nature to justify suspension of the practitioner from practising medicine or the removal of the practitioner’s name from the Register'.
More information on the Commission’s complaints process.
The Australian Health Practitioner Regulation Agency administratively supports the National Registration Boards, and offers a range of information on its website, including links to the websites of all National Boards.