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Iemma govt to strengthen protection against doctor misconduct

24 April, 2008

The Iemma Government has approved draft legislation to introduce mandatory reporting by medical practitioners of their colleagues in instances of serious misconduct.

Additions to the Medical Practice Amendment Bill 2008 that will introduce automatic suspensions for doctors who breach conditions on their registration and improve the transparency of medical disciplinary proceedings, were also supported by Cabinet.

NSW Minister for Health, Reba Meagher said the strengthening of the Bill followed the revelations of the handling of complaints about the conduct of Dr Graeme Reeves by regulatory and disciplinary authorities.

“The protection of the public is the paramount consideration when it comes to medical regulatory and disciplinary functions. That is why this legislation is timely and necessary,” Meagher.

In order to ensure that mandatory reporting serves its purpose of protecting the public and does not lead to a flood of tenuous and defensive reporting, practitioners will be required to have a reasonable belief that misconduct has occurred, not just a suspicion.

Mandatory reporting will be limited to three key areas of serious misconduct:

  • Sexual abuse in the practice of medicine;
  • Being intoxicated by drugs or alcohol while practicing medicine; or
  • Engaging in conduct while practicing medicine that is a flagrant departure from accepted standards of professional practice or competence and risks harm to another person.

“Revelations about the conduct of Dr Reeves over a long period of time have understandably reinforced concerns that some doctors are reluctant to report misconduct by their colleagues,” Meagher said.

“A Code of Conduct that set a professional and ethical obligation for medical professionals to report was introduced in July 2005, but the public perception of a ‘closed shop’ culture and of a profession that closes ranks around its own remain in place today.

The additions to the Medical Practice Amendment Bill 2008 recommended by the O’Connor review include proposals to:

  • Introduce a guillotine provision that allows the identification of serious conditions which, if breached, would warrant immediate suspension or deregistration;
  • Require the urgent section 66 reviews – those that consider the suspension of a medical practitioner – to include non-medical representatives;
  • Require Professional Standards Committees – those that judge if standards have been compromised – to include a legal representative to chair proceedings;
  • Overturn and reverse the current presumption that Professional Standards
  • Committee hearings are confidential and their findings should not be published;
  • Require the registration authorities to consider complaints in re-registration applications and proceedings, including those complaints received after deregistration has occurred.

“These changes have been informed by a review commissioned in February and carried out by Justice Deirdre O’Connor, to ensure we have appropriate safeguards in place,” Meagher said.

“I think the community wants more assurance that if a doctor breaches a serious condition that is attached to their registration then they face being immediately suspended or deregistered,” Meagher said.

“Improving the transparency of decision making means greater public knowledge of outcomes and a better understanding of how those outcomes are reached.”

The changes complement the Medical Practice Amendment Bill which has been drafted and specifically strengthens medical regulation in two areas:

  • in dealing with emergency situations; and
  • in addressing multiple complaints and patterns of poor conduct.

“We have seen recently that cases do arise where a doctor has been subject to a number of complaints going back over many years, complaints which show a pattern of poor standards or inappropriate conduct,” Meagher said.

“The current legislation focuses on resolution and investigation of complaints on a case-by-case basis rather than looking at a pattern of poor standards or inappropriate conduct.

“This Bill will provide for the professional disciplinary bodies – including the NSW Medical Board, Health Care Complaints Commission and the NSW Medical Tribunal – to take into account a doctor’s history of complaints when making investigation, prosecution and disciplinary decisions.”

The Bill also provides for improvements to the emergency provisions in section 66 of the Act, which allows NSW Medical Board to act urgently to suspend the registration of a medical practitioner in order to protect the life or physical or mental health of any person.

The changes will be tabled in parliament at the next sitting in early May.

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