Regulation of the medical profession
The Australian Health Ministers’ Advisory Council and the Medical Board of Australia have kept the Medical Practice Committee busy with two major projects this year: the proposed revalidation scheme in Australia and the Independent Review of Accreditations Systems within the National Registration and Accreditation Scheme (NRAS).
We have recently been formulating the AMA’s submission to the Medical Board of Australia’s interim report on revalidation. Because of the far reaching implications of the proposed system, this submission was also considered by Federal Council prior to lodgement with the Medical Board.
The AMA has been working with the Medical Board from the start of the process to help in ensuring a sensible approach to revalidation in Australia. Our fundamental principle has been to only support a revalidation system where the benefits to the community clearly outweigh the costs.
The AMA has consistently argued that if any form of revalidation is to be developed and introduced, the Medical Board must clearly define the problems it believes exist, and demonstrate that its proposed response will address these problems, especially given that only a small proportion of doctors are the subject of formal complaints from patients or colleagues.
Our submission advocates that the colleges, societies and associations be fully involved in the development of any changes to CPD requirements to minimise the risk that ‘the goal posts will be moved’ once a system is in place.
The submission also notes that without a problem or an end goal, the impact of a proposal to mandate a strengthened CPD program remains unknown.
We do not support the ‘At risk and poorly performing medical practitioners’ proposal in its current format. This proposal requires considerable further development before it can be properly considered. Any further changes to the requirements should simply enhance the operation of the existing regulatory system, rather than impose an additional burden.
The AMA has requested that the Medical Board consider the feedback received from the public and the medical profession and refine their proposal with a view to conducting another round of consultations with the profession.
The Australian Health Ministers’ Advisory Council has commenced the Independent Review of the Accreditation System within the NRAS and appointed Professor Michael Woods as the independent reviewer on 10 October 2016.
The Accreditation Systems Review will address:
- the cost effectiveness of the existing systems for the delivery of accreditation functions;
- governance structures, including reporting arrangements;
- opportunities for streamlining accreditation processes, including consideration of other educational accreditation processes;
- the extent to which accreditation arrangements support educational innovation in programs including clinical training arrangements, use of simulation and inter-professional learning; and
- opportunities for increasing consistency and collaboration across the profession.
The Medical Practice Committee considered the implementation of the NRAS and noted that the NRAS has met the expectations of the medical profession in respect of:
- registration arrangements that enable medical practitioners, who are qualified and safe, to work anywhere in Australia;
- independent accreditation of medical education and training that meets international guidelines; and
- medical practice registration standards set by the Medical Board, with clear jurisdiction over all health care provided by medical practitioners.
Committee members also agreed that while there is a robust process to oversee applications for prescribing by non-medical practitioners, there remain concerns that patient safety has not been a primary focus.
Of greater concern were non-medical practitioner bodies setting guidelines that seek to increase their scope of practice without any independent oversight.
The first issues paper on governance arrangements for the scheme has been disseminated and the Medical Practice Committee will shortly be developing a submission to this review. The paper focuses on the governance structures within the NRAS, with a view to removing gaps in the accountability arrangements for the scheme.
The AMA submission is due on 23 December.
Published: 12 Dec 2016