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NSW passes landmark legislation that aims to protect patients

10 June, 2008

New South Wales now has the strongest legislation in the country to protect patients against misconduct by doctors, after the Medical Practice Amendment Bill 2008 passed through the NSW Parliament.

Minister for Health Reba Meagher said the Bill provides a number of important changes, including the introduction of mandatory reporting by medical practitioners of their colleagues in instances of serious misconduct.

The Bill also introduces automatic suspensions for doctors who breach certain conditions on their registration and improves the transparency of medical disciplinary proceedings.

"These stronger laws follow revelations about the handling of complaints about the conduct of Dr Graeme Reeves by regulatory and disciplinary authorities," Meagher said.

"There is no doubt that the case of Dr Reeves has challenged the public perception of the medical profession and that is why the Iemma Government is working to restore that trust."

Mandatory reporting will apply to three key areas of serious misconduct:

  • Sexual abuse in the practice of medicine
  • Being intoxicated by drugs or alcohol while practicing medicine
  • 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.

Meagher said that 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.

"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 protects its own remain in place," Meagher said.

"These changes have also been informed by a review commissioned in February and carried out by Justice Deirdre O'Connor, to ensure we have appropriate safeguards in place.

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

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the current presumption that Professional Standards Committee hearings are confidential and their findings should not be published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

"It is clear the community wants more reassurance 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 Bill and also strengthen specific medical regulation in two areas:

  • in dealing with emergency situations, Section 66 of the Act
  • 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 former legislation focused 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, the Professional Standards Committee and the NSW Medical Tribunal - to take into account a doctor's history of complaints when undertaking investigation, prosecution and making 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.

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