Annual report 2019-20

Ombudsman and Commissioner’s message

The COVID-19 health emergency has affected Australians on every level in the 2019–20 financial year. I would like to take a moment to thank all health practitioners who have provided services to the community during this challenging time.

Our health regulators too have had to adjust swiftly to complex challenges. New measures such as the pandemic sub-register of health practitioners have been implemented to meet healthcare needs as they emerge. These difficult circumstances have required new ways of communicating and monitoring change. They have also led to unusual trends in our complaints data.

This financial year my office received 987 approaches, five per cent fewer than 2018–19. This contrasts with the continued significant increase in approaches we have received in the past five years. I note that the number of complaints that my office received remained stable (increasing by 2 per cent).

We have continued to strive for fair and positive change in the regulation of registered health practitioners for the Australian community.

This year we have collaborated with the Australian Health Practitioner Regulation Agency (Ahpra) and the National Boards to:

• address gaps in policies and procedures

• improve communication, particularly regarding explanations for decisions or actions.

This year is also remarkable because it marks the 10-year anniversary of the National Registration and Accreditation Scheme (the National Scheme). It is very rewarding to consider the major projects undertaken this year because they reflect how far my office has come, and how it has evolved to be a champion for fairness.

Richelle McCausland

National Health Practitioner Ombudsman

National Health Practitioner Privacy Commissioner

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Common complaints

As in previous years, most complaints received in 2019–20 related to the handling of a notification about a registered health practitioner.

Concerns were mostly raised by the person who made the notification, rather than the health practitioner who was the subject of the notification.

Many complaints were also about registration matters, particularly perceptions of unfair processes and policies.

A smaller number of complaints were received about the handling of privacy-related matters, the handling of FOI requests and other general concerns about health practitioner regulation.

Finalised complaints

Our office successfully finalised 567 complaints this financial year.

We finalised 130 investigations during 2019–20. Generally, investigations resulted in three outcomes:

• providing a further explanation to the complainant
• providing formal comments or suggestions for improvement to Ahpra
• assisting Ahpra to resolve the matter.

The most common investigation outcome (62 per cent) was providing a further explanation to the complainant about the decision or action they complained about (81 complaints).

Who complaints were about

The number of complaints we receive about each National Board appears to be linked to the size of the profession the National Board represents, as well as the number of notifications received about practitioners who are registered in each profession. All complaints we received involve Ahpra in some way. This is because Ahpra is the main point of contact for people interacting with the National Scheme.

As in previous years, most complaints to our office related to the regulation of the medical, nursing and midwifery, and psychology professions.

Where complaints came from

We receive complaints from across Australia and from people located outside Australia who have been in contact with Ahpra or a National Board.

As in previous years, most of the complaints to our office came from people located in Victoria. This trend is likely due to the large number of registered health practitioners who are part of the National Scheme in Victoria. We saw an increased number of complaints from people located in Western Australia. It is unclear why this increase in complaints occurred and we will continue to monitor this trend.

New South Wales and Queensland have different arrangements in place for making notifications about health practitioners, and these arrangements affect the number of complaints we receive from these locations.

FOI matters

In 2018–19 our office began a new role in relation to the oversight and review of FOI decisions made by Ahpra and the National Boards.

We recorded 21 matters relating to the Commissioner’s FOI powers this financial year. This is fewer matters than we received in the previous financial year (29).

The type of FOI matters we received was significantly different from the previous financial year. In 2018–19 most of the matters we received were applications made by Ahpra for an extension of time to process an FOI request (14). We did not receive any applications of this type in 2019–20. This suggests Ahpra has addressed FOI matters in a timely way this financial year. It also suggests that more applicants are aware of, and are willing to approach, our office for review of an FOI decision.

We received 14 applications to review an access refusal decision in 2019–20. These review applications related to Ahpra’s decision not to release documents or certain information requested by the applicant in their FOI request.

Six applications for a review of Ahpra’s internal review decision were also made. These requests for review were based on the decision Ahpra came to after it conducted an internal review of its original FOI decision in relation to the applicant’s FOI request.

Working with Ahpra

Our office works closely with Ahpra to achieve positive outcomes for the National Scheme.

When assessing and investigating complaints, we look for opportunities to work with Ahpra to quickly and effectively resolve complaints. This could involve asking Ahpra to reconsider a decision, issue an apology or refund a fee.

Improvements to Ahpra’s handling of complaints

We have been pleased to see further developments in Ahpra’s internal complaints management.

In particular, we have noted that Ahpra continues to improve the quality of its communications with complainants. Ahpra’s complaints team regularly provides comprehensive and detailed explanations to complainants in response to their specific concerns.

The timeliness of Ahpra’s responses to our investigations has also continued to improve.

Collaboration to improve communication

We have welcomed opportunities to discuss and make suggestions about how to improve public-facing information regarding Ahpra’s activities. This included providing comments on draft public communications in relation to:

• graduate registration
• advice about cosmetic surgery and procedures
• publishing links to tribunal and court decisions on Ahpra’s national register of practitioners.

This is an important proactive measure to reduce the number of complaints we receive as a result of misunderstandings or unclear information.

Working with the National Boards

Our office continues to collaborate wherever possible with the National Boards to ensure common complaint trends are addressed quickly and that our complaints data provides insight into the National Board’s important work.

This year, the Ombudsman and Commissioner was invited to present to a number of National Boards including the:

• Occupational Therapy Board in August 2019
• Medical Radiation Board in December 2019
• Pharmacy Board in April 2020.

In November 2019 we welcomed the opportunity to provide a response to Ahpra and the National Board’s public consultation on the review of the guidelines for advertising a regulated health service and the guidelines for mandatory notifications.