Annual report 2021-22
Learn more about how we achieved fair and positive change in the regulation of registered health practitioners in 2021-22
Ombudsman and Commissioner's message
This financial year was again dominated by ongoing challenges stemming from the COVID-19 pandemic. The pandemic continues to cause hardship, but I am acutely aware that it also demonstrates our community’s resilience and tenacity. I have seen these qualities in health practitioners undertaking their roles under new pressures. I see these qualities in community members sharing their concerns because they want others to have better experiences with Australia’s regulatory system. And I see these qualities in my staff, who continue to provide impartial yet empathetic complaint handling services while acclimatising to hybrid working.
My office’s role in providing free and independent complaint handling services to the public and health practitioners continued to evolve and grow this financial year. We received a record 1,593 approaches in 2021–22, a 65 per cent increase in approaches from last financial year. This included 731 enquiries (double the number received in 2020–21) and 823 complaints to the National Health Practitioner Ombudsman (up 42 per cent from 2020–21). This financial year has presented our greatest opportunity to identify and address issues raised with us to create fair and positive change in the National Scheme. Some of the most significant contributions we have made to the National Scheme’s improvement included:
- joining the expert panel for the independent review into the regulation of health practitioners in cosmetic surgery
- initiating a review into the implementation of the Australian Health Practitioner Regulation Agency’s (Ahpra’s) framework for identifying and managing vexatious notifications made about health practitioners
- continuing to ensure we make quality suggestions for improvement to Ahpra and the National Health Practitioner Boards (the Boards). This financial year, for example, we welcomed Ahpra’s updated service charter following my office’s reiteration of the importance of appropriate service standards to address ongoing communication issues.
I thank Ahpra’s leadership team and national complaints team for their professionalism and responsiveness to my office’s work and suggestions for improvement this financial year.
My office focused on making positive change in the most effective and efficient ways possible in response to the significant increase in our workload. This included further refining our complaint handling services to achieve early resolution outcomes. This would not have been possible without the dedication of my staff. It has been a pleasure to witness the increased connections between staff on returning to working from the office, and I thank my team for their creative and enthusiastic approaches to overcoming the new challenges we faced through these transitions.
Richelle McCausland
National Health Practitioner Ombudsman
National Health Practitioner Privacy Commissioner
Please note that post-publication a correction was made to Table 15 to reflect that the table relates to complaints received related to registration and registration applications received and finalised by Ahpra.
Ombudsman complaints
This financial year our office received 823 complaints to the Ombudsman. These complaints were made by 701 individuals, some of whom made multiple complaints to us during 2021–22. We most commonly received complaints about how Ahpra and the Boards handled a notification (38 per cent of complaints received). Eighteen per cent of complaints related to a registration matter. This represents a 10 per cent decrease in the number of notification-related complaints and a 24 per cent decrease in the number of registration-related complaints when compared with the previous financial year.
| Complaint type | 2019–20 | 2020–21 | 2021–22 |
|---|---|---|---|
| Handling of a notification | 351 | 344 | 309 |
| Pandemic policy or response[5] | N/A | N/A | 304 |
| Handling of a registration matter | 217 | 196 | 149 |
| Other complaint types | 27 | 14 | 32 |
| Concerns about customer service or how Ahpra handled a complaint | N/A | 27 | 29 |
| Total | 595 | 581 | 823 |
Pandemic-related complaints
We estimate 327 complaints to the Ombudsman related in some way to the pandemic in 2021–22, including 304 complaints where Ahpra and the Board’s pandemic policy or response was the main issue recorded on the complaint.[6]
During the pandemic, Ahpra issued position statements related to COVID-19 vaccination including the:
- Therapeutic Goods Administration’s (TGA) joint position statement regarding COVID-19 vaccinations dated 9 March 2021
- TGA’s joint position statement regarding the promotion of COVID-19 vaccinations dated 17 June 2021
- Boards, the Health Care Complaints Commission, the Office of the Health Ombudsman and the TGA’s joint statement on receiving COVID-19 vaccination advice dated 30 August 2021.
The most common themes we identified following a qualitative review of all pandemic-related complaints were about these statements. This suggests that directly or indirectly, 85 per cent of the pandemic-related complaints we received concerned Ahpra and the Boards’ vaccination statements. Most of these complaints were received during a surge in contact during November 2021 (269 complaints). This surge appeared to have been driven by a third-party social media post that promoted the use of our office’s online complaint form. Our office therefore received significantly fewer complaints related to the pandemic across the other months in the financial year (approximately 18 per cent of the pandemic-related complaints).
Our assessment of complaints related to these statements was that they were consistent with Ahpra and the Boards’ role in determining what is expected of registered health practitioners, as set out in the relevant professions’ codes of conduct.
Who complaints were about
As in previous years, most complaints to our office were about the regulation of the medical, nursing/midwifery and psychology professions. This financial year there was a significant increase in the proportion of complaints received about the regulation of the medical profession. In 2021–22 complaints related to the medical profession accounted for 70 per cent of all complaints compared with 46 per cent in 2020–21. There are likely many reasons for this increase; however, it appears to be largely driven by the increased number of pandemic-related concerns we received, which mostly related to the role of general practitioners regarding vaccination.
We saw a significant decrease in the proportion of complaints received about the nursing and midwifery professions (from 19 per cent of complaints in 2020–21 to 9 per cent in 2021–22), psychology (from 14 per cent in 2020–21 to 7 per cent in 2021–22) and dental professions (from 7 per cent in 2020–21 to 3 per cent in 2021–22).
Finalised complaints
This financial year our office finalised 881 complaints that were made to the Ombudsman, up from 544 in 2020–21. We finalised 198 complaints after using early resolution techniques (106 following an early resolution complaint transfer and 92 after making preliminary inquiries). Ninety-three complaints were finalised following an investigation.
Most complaints were finalised at the assessment stage of our complaint handling process (590). We finalised 165 per cent more matters at the assessment stage than in 2020–21, which was possibly due to the high number of pandemic-related complaints that we decided did not warrant any further action.
Outcomes
We recorded 1,231 outcomes across the 881 complaints our office finalised this financial year. This is a 97 per cent increase on the number of outcomes we recorded in 2020–21 (626). The average number of outcomes recorded on each complaint is largely consistent with 2020–21.
Preliminary inquiry stage
We finalised 92 complaints at the preliminary inquiry stage. This is consistent with the previous financial year (91 complaints finalised). The most common outcome was our office deciding that Ahpra or a Board’s response to our inquiries was fair and reasonable (38).
Early resolution transfer stage
In 2021–22 we assessed 130 responses Ahpra provided through the early resolution transfer process. Most of these complaints were finalised without further inquiries or investigation by our office (104 complaints; 80 per cent of assessed responses). This is a significant increase from the previous year when 63 per cent of complaints were finalised this way (104).
Investigation outcomes
We finalised 93 complaints following an investigation during 2021–22. We recorded 175 outcomes across these 93 complaints. Most investigations resulted in our office providing a further explanation to the complainant, followed by our office providing feedback to Ahpra.
The most common investigation outcome in 2020–21 was providing a further explanation to the complainant about the decision or action they complained about (80). This means we did not identify a major error in how Ahpra or the relevant Board handled the complainant’s matter. Instead, we helped the complainant to better understand how their matter had been handled. This is a consistent trend in our complaints data.
Complaints to the Commissioner
This financial year our office received 13 privacy complaints to the Commissioner. These complaints were made by 11 individuals. This is a significant increase in the number of privacy complaints we receive. For example, in 2020–21 we received three complaints and in 2019–20 we received one complaint. There are likely many reasons for this increase in complaints including greater awareness of our office and role in assisting with concerns about the use of personal information.
Most privacy complaints we received in 2021–22 related to the medical (7), nursing (3) and dental (2) professions. This is consistent with trends seen in complaints to the Ombudsman.
We recorded 20 issues across the 13 privacy complaints we received. We record privacy complaints differently from complaints to the Ombudsman. Privacy complaints to the Commissioner are recorded based on the Australian Privacy Principles (APPs). The most common issues we recorded in 2021–22 related to:
- APP 6 – inappropriate use or disclosure (10)
- APP 2 – anonymity and pseudonymity (3)
- APP 13 – correction of personal information (2)
- APP 12 – access to personal information (2).
We also recorded one issue related to APP 5 (notice about collection), APP 10 (quality of personal information) and APP 11 (security of personal information).
Outcomes of privacy complaints
Our office finalised 10 complaints made to the Commissioner this financial year. This is a significant increase from 2020–21 when we finalised two complaints. These complaints were finalised during the assessment (5) or the preliminary inquiry (5) stage. The most common outcome was our office deciding that an investigation was not warranted in the circumstances (7).
Notifiable data breaches we received
Each of the eight eligible data breach notifications we received this financial year related to Ahpra’s inadvertent disclosure of personal, sensitive or protected information. Notably, five of the notifications related to the disclosure of information about a confidential notifier to the practitioner who was the subject of the notification. The other eligible data breaches related to the inadvertent disclosure of information to a third party by email (2) and the inadvertent disclosure of a practitioner’s address to a notifier (1).
We decided that Ahpra had taken appropriate action to address the issue in six of the eligible data breaches. We provided guidance to Ahpra regarding further appropriate action to address two of the eligible data breaches. These outcomes suggest that Ahpra has generally appropriately responded to instances where a data breach has occurred.
Our office will continue to monitor the increase in the number of eligible data breaches to determine whether further action is necessary to address identified issues.
Freedom of Information
Our office provides oversight of Ahpra’s application of the FOI Act. Mostly, we provide oversight by considering applications to review a decision made by Ahpra under the FOI Act.
This financial year we:
- received 18 FOI review applications
- started 12 FOI reviews
- finalised 12 FOI reviews
- published two FOI review decisions.
This financial year we received 18 applications to review a decision made by Ahpra. This is a small increase in the number of applications compared with 2020–21 (16).
We received seven applications to review an access refusal decision and nine applications to review an internal review access refusal decision. This is consistent with the number of applications we generally receive. We also received one application to review an access grant decision and one invalid application where the applicant had not received an FOI decision from Ahpra.
Outcome of FOI review applications
In 2021–22 we finalised 12 FOI review applications. We finalised most applications at the assessment stage (5) and the review stage (5).
Two applications proceeded to a final determination by the Commissioner. In ‘AF’ the Commissioner set aside and substituted Ahpra’s FOI decision and in ‘AG’ the Commissioner affirmed Ahpra’s FOI decision.
Financial statement
The Victorian Department of Health provides financial services to our office. Our financial operations are consolidated with the department’s and are audited by the Victorian Auditor-General’s Office. A complete financial report is therefore not provided in this annual report.
A financial summary of the expenditure for 2021–22 is provided below and has been certified as true and correct by the department’s acting deputy chief finance officer.
| Retained earnings balance 1 July 2021[8] | $344,000 |
| 2021–22 revenue (invoices raised to Ahpra) | $2,640,000 |
| Expenditure for 2020–21 | |
| Salaries | $1,771,441 |
| Salary on-costs | $272,625 |
| Supplies and consumables | $437,933 |
| Indirect expenses (includes depreciation and long service leave) | $57,251 |
| Total expenditure | $2,539,250 |
| Balance as at 30 June 2022 | $444,750 |
Footnotes
[1] This estimate was gathered based on a keyword search of enquiries received in 2021–22 where the terms ‘COVID’, ‘COVID-19’ or ‘pandemic’ were mentioned in the summary of a case.
[2] This estimate was gathered based on a keyword search of enquiries received in 2021–22 where the terms ‘COVID’, ‘COVID-19’ or ‘pandemic’ were mentioned in the summary of a case.
[3] Please note that this figure is based on the primary issue ‘pandemic policy or response’ in complaints categorised by the type ‘Other.’
[4] We can record up to three outcomes on each individual complaint.
[5] We introduced this complaint type in 2021–22 to record pandemic-related complaints more accurately. Prior to the introduction of this complaint type, they had been categorised as ‘Other’ complaints.
[6] This estimate was gathered based on a keyword search of complaints received in 2021–22 where the terms ‘COVID’, ‘COVID-19’ or ‘pandemic’ were mentioned in the summary of a case.
[7] National Health Practitioner Ombudsman, Review of confidentiality safeguards for people making notifications about health practitioners, December 2019
[8] At the end of each financial year, we hold onto any unspent funds to invest in longer term projects.