National health practitioner regulation reform

Peter CarverExecutive DirectorNational Health Workforce Taskforce

10 December 2007

National health practitioner regulation reform Prime Minister requests Productivity Commission

to review health workforce Council of Australian Governments (CoAG)

requests CoAG senior officials to report on improving the supply, responsiveness and flexibility of the health workforce.

Productivity Commission Report 19 January 2006 21 recommendations for reform

Focused on significant structural reform of governance, education and training and funding structures

Emphasis on multidisciplinary approaches

National health practitioner regulation reformCoAG response Clarity achieved on differences between

Commonwealth and States but many common areas of agreement

Reform areas focused on promoting workforce flexibility, innovation and multidisciplinary approaches National agreement on annual planning health education

numbers through MCEETYA Minor expansion of access to MBS Reforming where medical specialist training takes place Funding and structures to progress reform and innovation

(National Taskforce) National schemes for registration and health professional

course accreditation

National health practitioner regulation reformNational health practitioner regulation reform

National Health Workforce Taskforce

Other Principal Committees

Aboriginal & Torres Strait Islander

Health Workforce Working Group

Australian Health Ministers Conference

Australian Health Ministers’ Advisory

Council

Health Workforce Principal Committee

Practitioner Regulation

Subcommittee

Mental Health Workforce Advisory

Committee

Australian Health

Ministers Council

Committee Structure

National health practitioner regulation reformNational Health Workforce Taskforce Primary vehicle for driving reform Established for four years Budget of approximately $34M over 4 years (all

sources)

National health practitioner regulation reform

Research

&

Workforce Planning

HWPC support

Innovaton

&

Reform

National scheme for registration and accreditation

Australian Constitution does not give power to the Commonwealth for health professional registration and accreditation Queensland Government will pass primary legislation Referencing legislation will be passed by other states and

territories Scheme will be covered by an Intergovernmental Agreement

Identifies objectives, governance arrangements, scope, legislative arrangements and financial arrangements

Once signed, health ministers to take responsibility for implementation

Scheme will cover doctors, nurses, dentists, pharmacists, physiotherapists, psychologists, chiropractors, optometrists and osteopaths in the first instance

Upon signing of IGA all partially registered professions will be reviewed to determine whether they should be included in the

new scheme as soon as possible (if not immediately) upon national scheme commencement

National scheme for registration and accreditationWhat must a national system be? Its overriding interest should be the safety and quality of the

care that patients receive from health professionals It must be grounded in a solid legal framework It must sustain the confidence of both the public and the

professions through demonstrable impartiality and both real and perceived independence

It should sustain, improve and assure professional standards as well as identify and address poor practice or bad behaviour

It should not create unnecessary burdens, but be proportionate to the risk it addresses and the benefit it brings

It must be sufficiently flexible to work effectively for the different and evolving health needs and healthcare approaches across Australia

National scheme for registration and accreditationWhat things must a national system do? Create uniform national standards on which to base

professional registration and course accreditation Provide a consistent approach across Australia to

protection of the public Provide greater public scrutiny and consumer participation

in practitioner regulation Have regard to the public interest in promoting access

to health services Facilitate cross-profession approaches to health workforce

issues Remove impediments to more efficient workforce

deployment (both geographically and clinically)

National scheme for registration and accreditationWhat things must a national system do? Promote common codes and guidelines for practice Facilitate the provision of high quality education and

training Promote interdisciplinary and multidisciplinary education

and training and articulation between VET and higher education and training

Improve appropriateness and consistency of accreditation across professions and rigorous and responsive assessment of overseas-trained practitioners

Reduce administrative and compliance costs and reduce red tape for practitioners

National scheme for registration and accreditationWhat will a national system look like? Final framework of the Scheme yet to be finalised

with the signing of an IGA National and state based consultation have been undertaken

155 submissions from stakeholders Consultations will be ongoing

The “knowns” (and the “unknowns”) A national Scheme to be overseen by Australian Health Ministers

setting policy directions Ensuring regulation, standards and guidelines remain flexible

and responsive to consumer and health system needs Not intervening in individual decisions of the boards regarding

practitioners A national Scheme that will be self funding but with

establishment costs funded by governments

National scheme for registration and accreditation The “knowns” (and the “unknowns”)

A single national agency supporting profession specific boards A single grant of registration allowing practice across Australia A state and territory presence to handle enquiries, registration

applications and complaints linked to existing state and territoryreview mechanisms with determinations to have national effect

Profession specific boards made up of practitioners, consumers and others appointed on the basis of skills and experience andnot representing any particular interest group

Existing board members to be offered the opportunity to continue to participate through the state and territory presences

National scheme for registration and accreditation The “knowns” (and the “unknowns”)

Accreditation of health education requirements for registration provided with a legal framework as part of the registration function. Decisions relating to qualification assessment and course approval will continue to be independent in this framework

Existing accreditation bodies, providing they meet certain public interest standards, will be delegated the accreditation role for up to 3 years whilst the profession resolves how best to make this role work in the new national Scheme

That there are many “unknowns” that will require resolution in consultation with stakeholders

Resolving the unknowns provides the opportunity to draw on good systems across Australia and around the world to build the best in a national Scheme

National scheme for registration and accreditation The “knowns” (and the “unknowns”)

Provides the opportunity to resolve issues currently not well dealt with and link into other national initiatives, eg:

Certifying continuing professional competence/revalidation Long debate about whether the health professionals should

demonstrate objectively currency with professional and clinical developments

Trust alone no longer sufficient guarantee of fitness to practise. Public expect health professionals to be revalidated as part of annual registration and many believe that this already takes place

Registration, recruitment screening, revalidation, accreditation, credentialling and clinical privileging often traverse same space. National approaches to safety and quality accreditation are under consideration

A national Scheme provides the opportunity to better align these process, consider overlaps and provide a more integrated approach to practitioner and system quality

National scheme for registration and accreditationWhen will it happen? CoAG initially agreed to implementation of the national Scheme

by July 2008 Final framework of the Scheme yet to be finalised with

the signing of an IGA thus this date appears ambitious Once the IGA is signed a revised work program and timetable

will be developed for approval by AHMC A staged approach will enable the development and passage

of legislation in parliaments across Australia and a smooth administrative transition

This approach will allow further consultation with stakeholders to progressively resolve the complex policy, technical and logistical issues as they arise

National health practitioner regulation reform

Peter CarverExecutive DirectorNational Health Workforce Taskforce

10 December 2007