22 February 2023

Who pays for AHPRA’s plans?

AHPRA Political The Hill

The AHPRA CEO was grilled on how the regulator handles cases of doctor sexual misconduct at the Senate Estimates hearing.


The national regulator needs more funding, and there’s only one way to get it.

Appearing at the Community Affairs Legislation Committee estimates hearing on the health portfolio today, AHPRA CEO Martin Fletcher conceded that the body needs more resources, and the only way to raise resources is to up fees for health practitioners.

Much of the conversation focussed on a recent Four Corners investigation into doctors who have had findings of sexual misconduct made against them but have continued to practice.

In response to the Four Corners report, AHPRA issued a “blueprint to better protect patients from sexual misconduct in healthcare” earlier this week.

The reforms suggested in the blueprint include reviewing the criminal history registration standard, expanding on a pilot trial which provides support for sexual misconduct survivors during the regulatory process and commissioning research on the outcomes of sexual misconduct cases.

It also came up with suggestions that would need to pass as National Law amendments.

These included increasing the role of community members in decision making committees, creating a Charter of Rights for people who have experienced professional misconduct by a doctor and greater tribunal transparency.

The trial of expanded support options for people who have either been victim to practitioner sexual misconduct, Mr Fletcher told senators, has been so successful that AHPRA is eyeing a significant expansion.

“Initially, we saw the focus as being very much on the victim survivors, but in fact what we’ve found is that we needed to extend that support to the witnesses as well,” he said.

“So that’s been where we’ve pulled out the focus and why we think we need to put additional resources [into this program].”

When Greens Senator Larissa Waters queried Mr Fletcher on whether AHPRA could receive government funding to run or expand the program, he confirmed that the regulator could not do so.

Instead, Mr Fletcher said, AHPRA would have to look at raising the fees for health professionals.

“Each of the 15 health professions pay their own way in terms of how much it costs to regulate their profession under the national scheme,” he said.

“And to the extent that we might need more resources, what we have to look to is increases in those fees.”

During his time on the hot seat, Mr Fletcher also confirmed that the number of sexual misconduct reports made against doctors had been “trending upward” over the last decade.

“I think a light has been shone in this area … and people are more willing to speak up,” he said.

“What we’re also seeing at times is historical allegations … [and] whenever we get media coverage of this, we certainly get additional reports.”

Senator Waters also asked whether there was a risk that the tough KPIs for closing notifications at AHPRA – which some former staff members have alleged are difficult to meet – could mean that complaint investigators are disincentivised to take on complex cases.

“We’re looking at the lower risk areas in terms of concerns that arise with us, certainly aiming to resolve those as quickly as possible in the assessment phase,” Mr Fletcher said.

For the cases that do warrant an investigation, he said, the regulator is training specialist investigation teams.

“We have a specialist [investigations] team in relation to concerns we’ve got about health and impairment, which often needs quite a different approach to, say, a concern about the conduct of a practitioner,” said Mr Fletcher.

The senate estimates hearing also heard from the TGA’s Adjunct Professor John Skerritt, as well as representatives from the National Blood Authority, the Australian Digital Health Agency and the National Rural Health Commissioner.