If you are an Australian health professional and you have a health problem, there is a risk that your job is on the line if you seek medical assistance. But help is on its way…
As a result of mandatory reporting obligations under the National Law doctors and other health professionals may avoid seeking help or treatment for fear of being reported to the Australian Health Practitioners Regulation Agency (AHPRA) by their treating practitioner.
The reporting requirements were originally developed to protect the public against practitioners who have e.g. a health problem, an impairment or engage in serious misconduct.
Concerns have been raised repeatedly that health professionals are not seeking help and this has been flagged as a risk to the public in itself. Practitioners have also argued that their treatment should be kept confidential, just like every other Australian who seeks care.
Western Australia is the only state where these mandatory reporting guidelines are not applicable. Sadly, there is anecdotal evidence that this has created interstate traffic by practitioners in need of medical assistance.
The good news is that health ministers have reviewed this issue last month. The discussion paper ‘Mandatory reporting under the Health Practitioner Regulation National Law’ by the Australian Health Ministers’ Advisory Council (COAG) provides 4 options – of which 3 are new ones.
This is the least favourable option as it would mean no change. This option would treat impairment matters and other notifiable conduct identically, requiring treating practitioners to report any notifiable conduct as is currently the case.
This is likely the most favourable option from the perspective of health practitioners as it provides a complete exemption for treating practitioners from the requirement to report notifiable conduct in respect of their practitioner patients – similar to the Western Australian model.
Practitioners would have the same rights as any other Australian to seek care, without fear of being reported by their treating practitioner and recognising the importance of confidentiality.
This option would entrust the treating practitioner to make a voluntary notification in accordance with their professional and ethical obligations to protect the health and safety of the public.
When a patient poses a serious risk to the public, professional and ethical obligations require treating practitioners to report (even in the absence of a requirement to do so) and to encourage the practitioner that they are treating to self-report.
Other practitioners including colleagues and employers remain under a mandatory obligation to report impairment and other forms of notifiable conduct.
This option would only exempt treating practitioners from the requirement to report an impairment matter if it will not place the public at substantial risk of harm.
All other types of notifiable conduct, current or past, must be reported by a treating practitioner. This means that practitioners with for example a mental health or addiction problem may not disclose issues to their treating practitioner, or may avoid seeking help.
This option would exempt treating practitioners from reporting impairment matters and to only require reporting of other forms of notifiable conduct where there is a current or future assessment that the notifiable conduct is likely to occur.
This option creates problems with regards to for example risk assessment which is often based on past conduct. Health practitioners may not fully disclose health matters and avoid seeking help under this option.
The WA model
I expect that most practitioners will prefer option 2. This option allows full disclosure of health issues, facilitating diagnosis and treatment. It respects the confidentiality of the patient-doctor relationship which is the basis of a successful road to recovery.
The COAG discussion paper reports that an independent review found no evidence that the WA model impacted on notification rates, further supporting option 2 as the preferred nationwide solution.
Submissions from stakeholders must be sent to COAG by 29 September 2017.