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Inquiry Into National Registration and Accreditation Scheme for Doctors

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Inquiry Into National Registration and Accreditation Scheme for Doctors The Senate Community Affairs Legislation Committee National registration and accreditation scheme for doctors and other health workers August 2009 © Commonwealth of Australia 2009 ISBN 978-1-74229-160-4 Senate Community Affairs Committee Secretariat: Mr Elton Humphery (Secretary) Mr Ivan Powell (Acting Principal Research Officer) Mr Owen Griffiths (Senior Research Officer) Ms Leonie Peake (Research Officer) Ms Ingrid Zappe (Executive Assistant) The Senate Parliament House Canberra ACT 2600 Phone: 02 6277 3515 Fax: 02 6277 5829 E-mail: [email protected] Internet: http://www.aph.gov.au/senate_ca This document was produced by the Senate Community Affairs Committee Secretariat and printed by the Senate Printing Unit, Parliament House, Canberra. iii MEMBERSHIP OF THE LEGISLATION COMMITTEE 42nd Parliament from 14 May 2009 Members Senator Claire Moore, Chair ALP, Queensland Senator Rachel Siewert, Deputy Chair AG, Western Australia Senator Judith Adams LP, Western Australia Senator Carol Brown ALP, Tasmania Senator Sue Boyce LP, Queensland Senator Mark Furner ALP, Queensland Participating Members for this inquiry Senator the Hon Eric Abetz LP, Tasmania Senator Gary Humphries LP, Australian Capital Territory Senator John Williams NATS, New South Wales iv MEMBERSHIP OF THE COMMITTEE 42nd Parliament until 14 May 2009 Members Senator Claire Moore, Chair ALP, Queensland Senator Rachel Siewert, Deputy Chair AG, Western Australia Senator Judith Adams LP, Western Australia Senator Catryna Bilyk ALP, Tasmania Senator Carol Brown ALP, Tasmania Senator Sue Boyce LP, Queensland Senator Mark Furner ALP, Queensland Senator Gary Humphries LP, Australian Capital Territory v TABLE OF CONTENTS MEMBERSHIP OF THE COMMITTEE ................................................................................ iii RECOMMENDATIONS ......................................................................................................... vii CHAPTER 1 INTRODUCTION ..................................................................................................................... 1 TERMS OF REFERENCE ..................................................................................... 1 CONDUCT OF THE INQUIRY ............................................................................ 1 BACKGROUND .................................................................................................... 2 THE NRAS SCHEME ........................................................................................... 3 Legislative framework ......................................................................................... 3 Scope of NRAS ................................................................................................... 4 Objectives and guiding principles of NRAS ....................................................... 5 CHAPTER 2 DESIGN OF THE NATIONAL REGISTRATION AND ACCREDITATION SCHEME FOR DOCTORS AND OTHER HEALTH WORKERS ......................................... 7 INTRODUCTION .................................................................................................. 7 Changes to the proposed Scheme arising from national consultation .................... 7 ISSUES ................................................................................................................... 8 Independence of accreditation ................................................................................ 8 Directions on accreditation standards by Ministerial Council ............................ 8 Appointment of external accreditation bodies by Ministerial Council ............. 14 Other accreditation issues ..................................................................................... 17 Definition of 'accreditation standard' ................................................................. 17 Conditional accreditation................................................................................... 18 Composition of National Boards .......................................................................... 18 Representation of small jurisdictions ................................................................ 19 Composition of National Boards of particular professions ............................... 20 Psychology ..................................................................................................... 20 Dentistry ......................................................................................................... 21 Osteopathic .................................................................................................... 22 Mandatory reporting ............................................................................................. 23 Complaints ............................................................................................................ 27 Separation of complaints management and performance management ............ 27 Public Interest Assessor ..................................................................................... 28 Protection of titles ................................................................................................. 30 'Specialist' .......................................................................................................... 31 Profession-specific titles .................................................................................... 32 Spinal manipulation .............................................................................................. 33 vi Consultation on the NRAS ................................................................................... 36 Profession-specific issues ..................................................................................... 37 Podiatry .............................................................................................................. 37 Specialist registration ..................................................................................... 37 Optometry .......................................................................................................... 40 Exemption of orthoptists from optometrist practice restrictions ................... 40 Uniformity of state and territory laws outside NRAS ................................... 42 Psychology ........................................................................................................ 43 Adequate recognition of organisational psychologists .................................. 43 Scope of practice in psychological testing ........................................................ 44 Pharmacy ........................................................................................................... 45 Registration of pharmacy premises ............................................................... 45 Accreditation of specialist pharmacist practitioners ...................................... 46 Chiropractic ....................................................................................................... 46 Provision of chiropractic services about the jaw ........................................... 46 Midwives ........................................................................................................... 47 Issues relating to registration and indemnity insurance ................................. 47 CONCLUSION .................................................................................................... 47 COALITION SENATORS’ MINORITY REPORT ............................................................... 51 ADDITIONAL COMMENTS BY SENATOR RACHEL SIEWERT, THE AUSTRALIAN GREENS ............................................................................................... 53 APPENDIX 1 ........................................................................................................................... 55 LIST OF PUBLIC SUBMISSIONS, TABLED DOCUMENTS AND ADDITIONAL INFORMATION AUTHORISED FOR PUBLICATION BY THE COMMITTEE .............. 55 APPENDIX 2 ........................................................................................................................... 63 WITNESSES WHO APPEARED BEFORE THE COMMITTEE AT PUBLIC HEARINGS .............................................................................................................. 63 APPENDIX 3 ........................................................................................................................... 67 CHRONOLOGY OF NATIONAL REGISTRATION AND ACCREDITATION IMPLEMENTATION PROJECT EVENTS............................................................................ 67 vii RECOMMENDATIONS Chapter 2 Recommendation 1 2.28 The Committee recommends that the Australian Health Workforce Ministerial Council fully consider and evaluate the potential usefulness and feasibility of the proposed amendments to clauses 10(3) and 10(4) of the Health Practitioner Regulation National Law (Bill B), especially those proposed by the Australian Medical Association (AMA). Recommendation 2 2.176 The Committee recommends that the Australian Health Workforce Ministerial Council introduce a requirement into the proposed national registration and accreditation scheme (NRAS) that the reasons for issuing a direction in relation to an accreditation standard be made public. Recommendation 3 2.178 The Committee recommends that the Australian Health Workforce Ministerial Council ensure that the national registration and accreditation scheme (NRAS) contains sufficient flexibility for the composition of National Boards to properly reflect the characteristics
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