Optometry Australia (OA) has called into question the agility of the national registration and accreditation system, including the time it takes for Ahpra to respond to serious complaints like sexual misconduct, while also taking issue with tightened CPD requirements making it harder for optometrists to obtain exemptions while on parental leave.
The concerns form part of the peak body’s submission to a Senate inquiry earlier this year into the way the Australian Health Practitioner Regulation Agency (Ahpra) – and related entities under the Health Practitioner Regulation National Law – handles registrations and complaints, otherwise known as ‘notifications’.
OA has also raised concerns over the current framework for optometrists requiring supervision to practise, stating it is “difficult and stressful” to navigate, and a lack of support services specifically for optometrists subjected to a complaint.
The inquiry, undertaken by the Senate Community Affairs References Committee, was established in 2021 due to persistent issues with the administration of Ahpra registrations and notifications. Significantly, it found health practitioners and notifiers continue to experience delays, disappointment, confusion and stress with regulatory processes and outcomes.
However, it did note the difficult job of Ahpra with “an inherent tension” between potential community safety risks and health practitioners’ livelihoods.
The public OA submission focused on seven areas for improvement, beginning with amended continuing professional development (CPD) standards introduced in December 2020, affecting parental leave.
Prior to this, it said the Optometry Board of Australia (OBA) granted automatic CPD exemption of up to 12 months for planned parental leave, enabling optometrists to fully take leave from their career and professional obligations for up to 12 months, without leaving the profession entirely.
“However, from 1 December 2020, the OBA guidelines advised that exemptions would be considered on a case-by-case basis and only granted if the practitioner met the criteria of ‘exceptional circumstances’ that would not include parental leave (except potentially in the case of a multiple birth),” OA stated.
With an increasingly female-dominated and youthful profession (58% female vs 42% male), OA said many in the profession were impacted by these changes.
“Whilst an evolving profession, best practice standards do not typically change significantly for optometry within a 12-month period, and there is no reason to believe, or historical data to suggest, that an up to 12 months exemption from completing CPD presents any danger to the general public. Rather, we believe such exemptions are an appropriate approach that aligns with modern workforce standards and supports the health and wellbeing of new parents. It can also prevent unnecessary loss of highly trained and skilled professionals from the profession.”
The inquiry also sought feedback on the timeliness of Ahpra’s response to complaints. OA said there continued to be unacceptable delays, which can cause mental distress for practitioners who are subject to complaints.
OA also has major concerns over Ahpra’s “agility” to respond to serious complaints that could place the public at risk.
“We are aware of a case of alleged sexual misconduct reported in 2021 where Ahpra took two months to undertake what they termed ‘immediate action’ to suspend the practitioner as they felt there was a serious risk to the public while an investigation was launched. We believe this is a gross dereliction of Ahpra’s mandate to protect public safety,” OA said.
And when practitioners are required to work under supervision as a condition of their registration, OA said the process remained “complex, confusing and inefficient” for affected individuals.
“For example, currently an optometrist seeking to return to provide eyecare to their community needs to research and find a suitable supervisor before knowing what level of supervision (in-person, or on the phone) will be accepted by the [OBA]. This obviously makes it challenging to arrange a supervisor, who does not have clarity on what will be required from them,” OA explained.
“Further, the time between submitting an initial supervised practice application and receiving the board’s verdict can be lengthy, in some cases extending over months.”
When it came to the supports available to optometrists subjected to a complaint, OA said there was no services available like there are for dentists and midwives.
It said initial notification communications list “generic” mental health support services such as BeyondBlue which practitioners, like the rest of the community, may access.
“We question whether practitioners would pursue these avenues for support in this context,” OA added.
OA’s submission was one of 144 lodged as part of the initial inquiry process to address the Terms of Reference set by the committee. A final report with 14 recommendations was published 1 April, and the Federal Government is now required to respond within three months.
Senate Community Affairs References Committee – key recommendations:
• Ahpra and the national boards introduce a more flexible re-registration model across professions that would enable health practitioners to more easily
re-enter the workforce after a period of absence.
• Ahpra undertakes urgent and immediate action for supervisory failures and ensure that individual cases are not indicative of a systemic failure.
• All supervisors should have a direct point of contact within Ahpra that should be made available prior to any contractual arrangements being made, as well as throughout the entire supervisory period.
• Ahpra and the national boards undertake education and awareness activities, explaining notifications and other complaints pathways, with health practices and services.
• The Ministerial Council should consider reforms to the National Law to enable health practices and services to be referred low risk notifications to be dealt with in the first instance, and that Ahpra and the national boards have discretion to refuse these matters on that ground.
• Notification accepted by Ahpra be limited to clinical issues relating to patient safety.
• Ahpra and the national boards undertake an analysis of the cause of protracted notifications timeframes and identify ways to further improve timeliness.
• Ahpra and the national boards develop and fund a comprehensive strategy for providing tailored support for the notifications process to practitioners in all regulated professions.
All submissions can be found here.
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