Ophthalmic leaders have welcomed the candid, reform-focused message from Ahpra’s new CEO, Mr Justin Untersteiner, who used a major speech to acknowledge regulatory shortcomings and chart a course through pressing challenges like workforce shortages, telehealth, and the rise of artificial intelligence (AI).
Untersteiner, who began as the Australian Health Practitioner Regulation Agency (Ahpra)’s second-ever CEO in May 2025, spoke at the Australian Medical Association’s Colleges, Associations and Societies (CAS) meeting in Canberra on 23 June. His remarks were closely watched across the health professions, coming at a time of intense scrutiny on regulatory processes and amid growing concerns about practitioner wellbeing.
Much of his address focused on one of the most significant challenges for Ahpra: rebuilding confidence in the notifications system.
For the system to work, he acknowledged the patient complaints process needed to be timely, transparent, procedurally fair, empathetic and accessible.
But he wasn’t convinced the current end-to-end system was achieving this, leading to “a loss of confidence and a loss of trust in the scheme”.
Much of this was highlighted in an independent review by Ms Sue Dawson – the former NSW Health Care Complaints Commissioner – into “unproductive and unnecessary complexity” within the system that regulates optometrists, ophthalmologists and other health professionals. Publishing this so early in his tenure has allowed Untersteiner to hear many views about how his organisation is performing.
“The report is also sobering – it paints a bleak picture of our performance in several areas,” he said.
“There is a perception that we have moved too slowly, and at times taken decisions that appear to be made in isolation without a deep enough understanding about flow-on consequence and risks.”
This transparency was welcomed by Optometry Australia (OA) which acknowledged “the leadership shown” by Untersteiner in his address and welcomed his recognition of the need for “a more responsive and proactive approach to promoting safety in healthcare”.
“It’s encouraging to see a positive response to the recommendations made through the Dawson Review and recognition of the need to transform the notifications system to ensure both thoroughness and timeliness,” CEO Ms Skye Cappuccio said.
“Our members who have experienced a notification know that a timely approach is much needed.”
RANZCO similarly welcomed Untersteiner’s approach of crafting a “listening, learning and responsive” regulator.
“Wide stakeholder engagement is key to ensuring the important, and nuanced, work of health regulation meets the needs of the population and supports colleges and other groups in providing the very best in patient and community care,” president Professor Peter McCluskey said.
Discussing workforce strains, Untersteiner said it was an issue being felt in many jurisdictions globally, but highlighted local factors such as shortages in regional and remote areas, and the low numbers of Aboriginal and Torres Strait Islander health practitioners.
While he praised recent reforms such as the Kruk Review’s somewhat controversial faster pathways for overseas-trained professionals, he stressed that more was required to ensure Australians could access timely, affordable care.
“We need to accelerate accreditation reform, and we must work across the system to improve workforce outcomes in the health sector,” Untersteiner said.
On the workforce issue, Cappuccio said OA had been calling for regulatory reforms to support therapeutically- endorsed optometrists to work to their full scope, including through appropriate oral prescribing. The body also wants greater regulatory attention to issues affecting professional safety and performance, such as working conditions that limit clinical autonomy.
“These matters are critical to the delivery of timely patient care and to practitioner safety and sustainability,” she said.
Prof McCluskey said RANZCO agreed with Untersteiner’s summation that Australia is facing ongoing issues of supply and demand and questions around patient access and affordability.
“The college is already playing a constructive role in addressing these issues through initiatives like Vision 2030 and beyond. RANZCO is looking forward to working with Ahpra under Justin’s leadership,” he added.
Keeping pace
Untersteiner devoted significant time in his speech to the disruptive forces reshaping healthcare, from the growth of telehealth to the rapid advance of AI. He pointed to benefits such as greater flexibility and improved access to care but highlighted emerging regulatory risks.
This included concerns about telehealth being misused and causing harm, plus comments around how AI can produce efficiencies, access to information and automation of low-risk activities but could compromise patient safety through bias, privacy breaches, or misleading advice.
Cappuccio said with the evolving areas of telehealth and AI use in healthcare, OA recognised these as key areas requiring “strong, proactive guidance from the regulatory body to ensure patient safety”.
Throughout his address, Untersteiner underlined his vision for Ahpra to become a more responsive regulator. He has already spent his first two months in the role meeting with health ministers, colleges, associations and practitioners to hear their concerns directly.
“I am reminded as I meet with many across the professions and the communities that we serve that we live in a time of dramatic change,” he said.
“Geopolitical challenges are accelerating a loss of trust in institutions – an issue that has been on the rise in recent times and certainly impacts Ahpra and other authorities.”
Untersteiner made clear there would be no quick fix but stressed “the question is not whether Ahpra and the scheme should reform – the question is what does reform look like and when do we get there”.
“Australia’s health system is one of the most respected in the world. It can only maintain that reputation through a robust regulatory system that ensures the public can have confidence in the care they receive,” he said.
“The work we do together – across professions, jurisdictions and communities, underpins the safety, quality and trust that Australia’s rightly expect from their healthcare system.”
Cappuccio agreed there was a collective responsibility.
“We are committed to continuing to work with Ahpra, the Optometry Board of Australia and other key stakeholders to strengthen the optometry profession by building a more responsive and future-focused system that can keep pace with the changing needs of practitioners and the public alike,” she said.
More reading
Ombudsman reviewing Ahpra’s ‘vexatious complaints’ framework
Complaints against Australian optometrists hit a five-year high
Key findings from new Optometry Australia-backed workforce projections report
