Progressing reforms to the Health Practitioner Regulation National Law

At the COAG Health Council meeting on 31 October – 1 November 2019, Ministers considered the outcomes of the Stage 2 consultation process. Stakeholder advice and submissions provided important information that directly informed Health Ministers’ consideration. More than 20 proposals were agreed by Ministers for inclusion in the Stage 2 amendments to the Health Practitioner Regulation National Law (National Law). 

As detailed in the meeting communique, the amendments represent a second group of National Law reforms following the 2015 Independent Review of the National Registration and Accreditation Scheme (National Scheme). The reforms will help to improve the efficiency, fairness and responsiveness of the National Scheme for both health consumers and registered health practitioners.

Reforms agreed for inclusion are detailed in the State 2 summary table which includes, subject to targeted consultation, two additional proposals to strengthen public protections under the National Law. Stakeholder submissions will be published shortly and will be available here.

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Consultation paper: Regulation of Australia's health professions: keeping the National Law up to date and fit for purpose

Released: 30 July 2018

Closed: 30 October 2018

Consultation on the second stage of reforms to the National Law took place in 2018. Stakeholder views on potential reforms detailed in the consultation paper were sought.

Submissions from stakeholders were analysed to inform policy proposals and recommendations for consideration by Ministers.

Regulation of Australia's health professions: keeping the National Law up to date and fit for purpose (PDF)

Regulation of Australia's health professions: keeping the National Law up to date and fit for purpose (Word)

 

Documents were provided to help stakeholders prepare responses:

 

The Guide to the National Registration and Accreditation Scheme for health professions provides an overview of the National Registration and Accreditation Scheme (NRAS).

All submissions are considered public documents and may be posted on this website, unless marked ‘private and confidential’. Additional information about the publishing of submissions, privacy and confidentiality is included in the response template.

 

Progressing reforms of the Health Practitioner Regulation National Law

An Independent review of the National Registration and Accreditation Scheme (NRAS) for health professions was undertaken in 2014–15. The NRAS Review recommended a number of reforms to the Health Practitioner Regulation National Law (the National Law) which are being progressed in stages:

 

 

Stage 1

 

In 2017, the first stage of amendments were made to the National Law following extensive consultation as part of the NRAS Review. Further targeted consultation on the draft Bill was undertaken in February 2017, and this first stage of legislative reform was completed when the final provisions in the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2017 commenced on 1 December 2018.

Key reforms in Stage 1 included:

  • national registration for the profession of paramedicine;
  • a new power for the COAG Health Council to change the structure of National Boards by regulation following consultation;
  • recognition of nursing and midwifery as separate professions;
  • strengthening notifications management and disciplinary and enforcement powers to improve their effectiveness and administration, and better protect the public, and;
  • technical and miscellaneous amendments to improve the efficiency and effectiveness of the National Law.

The Summary of the draft Health Practitioner Regulation National Law Amendment Act 2017 (the stage 1 Amendment Bill) provides a detailed explanation of the reforms in the draft Bill. The Frequently Asked Questions (FAQs) and Supplementary FAQs provide additional information. These documents include specific information relating to registration for paramedics.

 

Stage 1a

 

In March 2017, Ministers requested further urgent reforms to the National Law in relation to strengthened penalties and interim prohibition order powers and in August 2017, Ministers requested urgent advice on nationally-consistent mandatory reporting provisions under the National Law to developed before the Stage 2 process. In April 2018, Ministers agreed a nationally-consistent approach to mandatory reporting. The approach provides exemptions from the reporting of notifiable conduct by treating practitioners (noting Western Australia’s current arrangements are retained) that will be subject to formal approval by jurisdictions in certain circumstances. Further information on these reforms is provided  in COAG Health Council communiques.

The Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2018 was introduced to the Queensland Parliament in October 2018 and referred to its Health Communities, Disability Services and Domestic and Family Violence Prevention Committee. In February 2019, the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 was passed by the Queensland Parliament. Provisions relating to increased penalties for holding out and related offences commenced on 1 July 2019, with the remaining provisions relating to mandatory reporting reforms planned to commence in late 2019 or early 2020.

 

Stage 2

 

In July 2018, the second stage reform process began with the release of the consultation paper, Regulation of Australia's health professions: keeping the National Law up to date and fit for purpose. As well as implementing the remaining key reform proposals arising from the Independent Review that were not addressed in the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2017, the Stage 2 process also includes:

  • additional issues and proposals raised by Ministers, jurisdictions, the Australian Health Practitioner Regulation Agency, the National Health Practitioner Ombudsman and Privacy Commissioner and external stakeholders;
  • recommended legislative reforms arising from other inquiries and reviews, and;
  • issues raised during consideration of the stage 1 Amendment Act.

At its meeting of 31 October-1 November 2019, the COAG Health Council agreed amendments to the National Law and other non-legislative actions arising from the Stage 2 consultation process. The agreed reforms will improve the capacity of the national health professions regulatory scheme to protect the public by:

  • increasing regulatory oversight and control of rogue and unregistered practitioners;
  • improving the administrative operations and efficiency of the national health practitioner registration and accreditation scheme;
  • promoting better cooperation and information-sharing between regulatory and other government agencies providing or interfacing with health services and the health system, and;
  • addressing important, stand-alone issues such as the cultural safety of Aboriginal and Torres Strait Islander Peoples using services provided by registered health practitioners.

The meeting communique provides further information. Agreed reforms are detailed in the Stage 2 summary table (above).
 

Review of NRAS Governance

A review of the governance and reporting arrangements of the NRAS was established in 2016 following Health Ministers’ response to the independent NRAS review (the 2014 Snowball Review).

The Governance Review examined ministerial accountability in relation to the achievement of NRAS statutory objectives and the efficiency and effectiveness of NRAS entities in achieving those objectives. The review of NRAS Governance was undertaken by a working group made up of NSW and SA jurisdictions and the AHPRA Agency Management Committee, and involved targeted stakeholder consultation. The review’s final report was completed in November 2017 and made 14 recommendations.

The Final Report is available here. On 12 February 2020, Health Ministers released a communique (available here) announcing the COAG Health Council’s response to the review. Legislative amendments arising from this review will be progressed as part of the Stage 2 process.