Senate inquiry hears of disarray in new national health practitioner registration system
The Federal Government’s Australian Health Practitioner Regulation Agency’s (AHPRA) has come under criticism from across the health care industry for problems and inefficiencies in administering the registration of health practitioners.
The Senate Finance and Public Administration Committee inquiry into the administration of health practitioner registration by AHPRA has received 238 submissions from organisations and individuals, many highlighting concerns about delays in processing health practitioner registration, in many cases resulting in practitioners being unable to operate as their registration had expired.
AHPRA came into operation in July last year as a result of the Intergovernmental Agreement in March 2008, which resulted in replacing a complex system of state and territory based jurisdictional registration, across ten discrete health professions, with a nationally operated scheme under one piece of national legislation.
In its submission, the Royal Australian College of General Practititoners (RACGP) said it had been contacted by a number of members whose registration had lapsed because AHPRA had not processed their registration renewal
in a timely manner.
“In these situations, general practitioners are unable to see their patients as they are no longer registered. This causes unnecessary angst for the affected patients and general practitioners, can put the general practitioner’s credibility at risk as they are in effect ‘de-registered’, and ultimately leads to reduced workforce capacity.”
The RACGP also listed concerns about:
- The limitation of International Medical Graduates to work in multiple locations as their registration limits them to a provider number in a single location only;
- Inaccuracies in the AHPRA database with, for example, RACGP members finding that their registration category is listed as “general”, as opposed to “specialist”, despite being Fellows of the RACGP and therefore recognised specialist general practitioners;
- Lack of accessibility to AHPRA staff to clarify registration issues;
- Inconsistencies from state to state, with a number of state registration offices continuing to implement previous state-based policy
- The requirement under national registration arrangements that all medical practitioners must pay the full registration fee, fulfil the continuing professional development;
- Requirements of the relevant specialty, and have recency of practice, effectively precluding retired and semi-retired medical practitioners from any continued involvement in their profession.
The The Australian Physiotherapy Association (APA) recommended that AHPRA should increase its staff levels at critical renewal periods and suggested that a call centre be placed on standby to take over-flow calls.
APA noted that Physiotherapists who were unaware of their registration lapse were in some cases still practicing in their profession.
“The unregistered status of practitioners meant that any patients treated under workers’ compensation schemes, motor vehicle accident insurance schemes, Medicare, Department of Veteran’s Affairs (DVA) or private health insurance, were not eligible for rebates. The APA’s research indicates that this constitutes about 86% of all physiotherapy clients in private practice.”
“These physiotherapists could also face significant professional and financial risk as most professional indemnity insurance policies are voided if the policyholder becomes deregistered.’
The Australian College of Nurse Practitioners (ACNP) reported in its submission that since AHPRA commenced operations in July last year, a system for reviewing applications has been unavailable.
“Applications have sat for over eight months with no assessments occurring at many of the state/territory branches for the Australian Health Practitioner Regulation Agency (AHPRA). Nurses waiting for their applications to be processed so that they could gain endorsement and commence work as a NP were held up due to fact that no guidelines had been made available to the branches detailing how to process the applications. This had financial and professional ramifications for not only the NPs, but the Australian community who was not able to benefit from the timely care and reduced waitlist for specialist services that these NPs could have provided.”
The ACNP called for new registration standards to be made available on the AHPRA website for NPs, and adequate resources to be made available to process the back log of Nurse Practitioner applications.
More details about the Senate inquiry are at http://www.aph.gov.au/senate/committee/fapa_ctte/health_practitioner_registration/index.htm