The ophthalmic sector is backing a push to improve the way the health industry watchdog handles patient complaints, after a recent forum heard how drawn-out cases adversely impact the mental health and livelihoods of practitioners.
It comes as the National Health Practitioner Ombudsman (NHPO), Ms Richelle McCausland, investigates the way the Australian Health Practitioner Regulation Agency (Ahpra) and National Boards are using “immediate actions” – when the regulator can swiftly suspend a practitioner or impose conditions on their registration before the matter is resolved.
Although intended to protect the public from serious risk, the regulator has been criticised for using this “extreme power” too easily by the Australian Medical Association (AMA) , which points to cases of practitioners “languishing for years” while waiting for an outcome.
In the 2023-24 period, immediate action was taken against 1,215 practitioners in Australia. There was one case in New South Wales involving an optometrist (suspended), and 557 against medical practitioners (although this is not broken down by specialty).
Dr Danielle McMullen, AMA president, was at the April 2025 ‘Ahpra: Shaping better regulatory experiences forum’ in Melbourne with leaders and representatives of all regulated health professions, including Optometry Australia (OA).
She said the meeting’s purpose was to outline the learnings and changes Ahpra had implemented out of a 2023 research paper, which found at least 16 practitioners had died by suicide while subject to a notification, or patient complaint.
“I was appalled at the findings, but sadly not surprised. For years, the AMA has highlighted the impact notifications have on the lives of medical practitioners, despite the vast majority resulting in no actions,” she said.
She said the forum heard deeply personal and confronting stories about vexatious complaints, colleagues who died by suicide while under investigation, and the challenges of managing a notification alongside underlying mental health issues.
Also discussed were recent, tangible changes Ahpra had made to support practitioners under investigation.
According to Dr McMullen, these included restructuring how notifications are handled so a peer (i.e. doctor) reviews health-related notifications early on, improvements to ensuring there is a clear point of contact at Ahpra, and resolving low-level notifications prior to informing practitioners.
But more work was needed, Dr McMullen said, especially around immediate actions.
The AMA’s submission to McCausland’s NHPO investigation made clear Ahpra’s immediate action powers “must be used judiciously and balance protection of the public with the rights and wellbeing of practitioners”.
The Australian Society of Ophthalmologists (ASO) echoed the AMA’s concerns. ASO president Dr Peter Sumich said Ahpra needed “to respond appropriately to protect doctors and patients, realising that the final truth is not knowable until the determination”.
Dr McMullen said there were examples of the power being used when it was unclear what the risk to the public was. Plus, practitioners had been left waiting for years with minimal communication from Ahpra.
“Clearly, Ahpra needs greater accountability when it takes immediate action,” she said.
Immediate action was one of “the strongest sanctions available to Ahpra”, Dr McMullen said, leading to suspension or conditions when “allegations have been made, but before any wrongdoing is proven”.
“Such an action implies guilt before innocence can be proven, and can inflict irreparable damage to a practitioner’s reputation, derailing their career and their relationships with patients, colleagues, and employers,” she said.
Dr McMullen said the AMA’s submission outlined Ahpra and the Medical Board of Australia (MBA) had little accountability to the practitioner once immediate action was used.
The body recommended changes to the Health Practitioner National Law to mandate that Ahpra had a “duty of care to the registrant” and, in particular, a duty to minimise the mental health impacts and financial effects on the practitioner.
It also argued the MBA should be required to present to the NHPO within one week of taking immediate action to justify the action, and to outline a reasonable timeframe for resolution of the investigation.
Optometry’s voice heard
OA reviewed the NHPO consultation and supports the ombudsman’s work, but because none of its own members had been involved in the immediate action process for close to a decade, it wasn’t able to provide topical feedback on practitioner concerns related to the process.
However, OA chief clinical officer Mr Luke Arundel said his colleague, OA director of professional services Ms Sophie Koh, also recently attended Ahpra’s ‘Shaping better regulatory experiences forum’ in Melbourne.
This was so “optometry’s voice was heard on the need to ensure that due process and faster resolutions are being prioritised with all notifications to minimise adverse mental health outcomes for practitioners under investigation”.
“Sophie was invited to be a panellist and continues to be on Ahpra’s working group on the practitioner distress matter,” Arundel said.
“As a registered practitioner has a 38% chance of receiving a notification over a 30-year career, ensuring Ahpra balances patient safety with the welfare of optometrists remains a priority for Optometry Australia.”
In 2023-24, there were 34 notifications, closed against optometrists, with 44% of those leading to no further regulatory action, including where the practitioner had taken steps to address the issue.
More reading
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Ombudsman reviewing Ahpra’s ‘vexatious complaints’ framework
Complaints against Australian optometrists hit a five-year high
