Greater scrutiny of sexual misconduct in the healthcare system has led to sustained jump in reports to authorities as well as the number of practitioners facing regulatory action to protect the public, industry regulator Ahpra says.
New data reveals 841 allegations of ‘boundary violations’, including sexual misconduct, were made to the Australian Health Practitioner Regulation Agency (Ahpra) in 2022-23, with the allegations relating to 728 registered health practitioners. As a result, Ahpra has increased its specialist investigations staff headcount by 10.
The latest complaint figures are 50% higher than the number of reports two years ago, when Ahpra introduced new complaint categories as part of wider measures to stamp out sexism, sexual harassment or gendered violence in healthcare. This year’s complaints also follow on from a record 925 boundary violation allegations received last year.
Across the 16 professions, medical practitioners, which covers ophthalmologists, remain the most complained about with 359 followed by 215 complaints about nurses and 120 about psychologists. There has also been a steady rise in complaints about physiotherapists, with 33 sexual boundary notifications relating to that profession in 2022-23.
Optometry has consistently had one of the lowest complaint rates, with just nine alleged boundary breaches since 2012-13.
Generally, Ahpra says the types of complaints range from inappropriate or sexualised remarks, intimate touching of a patient without consent, personal relationships where there is an imbalance of power, to aggressive sexual, criminal offending. A boundary violation is behaviour that blurs professional and personal relationships with patients or involves unethical behaviour of a criminal or sexual nature with a patient or other person.
Ahpra CEO Mr Martin Fletcher said the also underlined the importance of a continuing push to better support patients speaking up, and the regulator’s investment in an increased number of specialist investigators and support services.
“While it’s distressing to hear about any case of sexual misconduct in the health system, it’s even more devastating if these incidents go unreported,” Fletcher said.
“Greater reporting provides greater opportunity to act. When we are told of instances where practitioners are failing to behave ethically and professionally, we have opportunities to respond.
“Increasing the number of team members dealing with these matters means we can reduce investigation times and reach an outcome quicker. More specialist investigators and social workers are being deployed to support people who are reporting their experiences with Ahpra.”
Ahpra’s specialist investigation team has been bolstered by another 10 full-time staff, growing the unit’s capacity by another 13.5% over the next year, on top of steadily increased investment in resources and training since the team’s inception in 2018.
Ahpra has also expanded its Notifier Support Service led by social workers which provides support and help to victims and survivors navigate the regulatory and tribunal process. The NSS pilot program has meet a significant need, receiving 278 referrals since its commencement in September 2021.
More than 850,000 health practitioners are registered in Australia and fewer than 2% have a notification made relating to their practice or behaviour for any reasons each year.
More than 1,000 boundary violation notifications were dealt with across the financial year, with a record 114 referred to independent tribunals for disciplinary action. A further 239 resulted in regulatory actions such as restricted practice, education or cautions.
Ms Christine Gee AM has been close to this work for many years as one of the founding members of the Medical Board of Australia’s specialist committee, established in 2017. She has seen the changes in approach to these cases as well as the change in the public conversation about sexual misconduct in health settings.
“The whole system has been improved and strengthened. Any hint of departure from appropriate professional boundaries is escalated quickly,” she said.
“The committee has zero tolerance for sexual misconduct, and we will recommend immediate action to place strict conditions or temporarily suspend a practitioner if we’re concerned about risk to the public while we investigate. It is so encouraging to see more patients reaching out each year to tell us about their experiences, as difficult as it is for victims to share their stories.”
An investigator in the Ahpra specialist investigation unit, trained to respond to these matters and support notifiers as the one direct contact throughout their journey with Ahpra said: “It’s about creating a safe space to tell these stories. Some of them are hard to hear, but all are important to report. We want to hear the big and small matters, because sometimes the small ones lead us to identifying bigger problems.”
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