Think of the medical practitioners

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It's Never Okay campaign (Screenshot via YouTube)

Medical professionals are not being supported by the health care system and government, writes Dr Don Kane.

HEALTH PROFESSIONALS AUSTRALIA REFORM ASSOCIATION (HPARA) was formed and registered as a limited guarantee not-for-profit company in 2015. There are seven foundation members, four of whom became directors.  

The principal aim of HPARA is to reform health care regulation in order for Australia's health care system to be at its best, both for its professionals and its patients. This, of course, can only be achieved by the system ensuring that doctors and professionals are protected from bullying and similar adverse action.

There have been significant changes in workplace culture over the last two decades that have seriously impacted upon health services delivery. This has had disastrous consequences for health professionals, many of whom have been dishonestly referred to the Australian Health Practitioners Regulatory Agency (AHPRA). Many of the shortcomings of the agency were revealed in the two Senate inquiries in 2016 and 2017 that have prompted no meaningful response from politicians nor health administrations.

All but one of the directors of HPARA and the majority of health practitioner members have been victims of abuse of the AHPRA notification system, which exists under the guise of mandatory notifications. AHPRA has frequently acted without offering the individual – who has been complained about – due process, natural justice and the presumption of innocence.

Thus, inhibiting conditions have been placed on the practice of the notified practitioner, such as Riyad*, before an investigation of the complaint has taken place. Often these have been placed on the AHPRA public record. Investigations by AHPRA can take a long time — Riyad's took two years and a month, in which a cascade of notifications was lodged over time. All were found to be unsubstantiated against him.

Riyad was then notified by AHPRA of the findings, headed by an apology from the board.

Riyad was a leader in his field. He initially gained his primary medical education and specialist qualification in his country of birth and subsequently worked in the UK and two tertiary metropolitan hospitals in Australia. Riyad was obliged to sit the examinations for entry to the Australian specialist college and was successful.

He had attained qualifications in his area of speciality in two countries that are recognised as having excellent standards as well as having worked in the UK without any problems.

Riyad moved to a regional area that services a population of 750,000 and established a busy, highly successful practice as the only practitioner in his field. Other practitioners banded together and notified him to AHPRA.

The apology and findings from AHPRA were far too late. Riyad was devastated by the events. He was rescued from a well-known suicide site late one evening by his Australian-born wife. Together with their two Australian-born children, they returned to his native country. Riyad has since developed a busy practice in his area of speciality.

* Riyad is a pseudonym 

There are many similar cases to this example among the HPARA membership.

No doubt non-members have been affected by such complaints as well.

HPARA members are not the only ones harmed by these events. The whole community suffers the loss of services provided by those who have been wrongly targeted. These services are often difficult to replace and the reputation of organisations as employers are brought into question.

There is no clear pathway within the current system to achieve justice for our members. We have attempted to encourage politicians to act. There has been no indication that they are interested in rectifying this problem.

This is, of course, despite Senate inquiries in 2016 and 2017 that exposed the deficiencies within AHPRA. Medical indemnity insurance providers have also been ineffective in providing the necessary mechanisms to provide the necessary services.

The only way that members can get recompense appears to be via legal action against the perpetrators of their plight. This is no easy task, considering the financial costs involved in engaging lawyers to represent victims and their families.

Let's remember they've not only suffered financially, but also professionally, psychologically and matrimonially.

Children have been left with only one parent because of such events and lives lost.

HPARA is unaware of any action by AHPRA to penalise those who have lodged dishonest notifications to AHPRA. The HPARA board has set up a GoFundMe facility, enabling it to provide funding for members to undertake legal action against those who abuse the system.

The HPARA board (including myself) welcomes contributions to the fund that will be used exclusively to assist members and their families to seek compensation.

Other groups apart from health professionals such as students – some of whom are HPARA members – have experienced problems such as bullying, improper advances and other threats.

A recent article published by Independent Australia, 'The struggle of being an international medical student in Australia', revealed the difficulties experienced by overseas-born recent graduates from medical schools in Australia. They've had extensive trouble obtaining internships in Australian hospitals to attain registration as medical practitioners in Australia. This is a waste of money spent on training them and is nothing short of a personal calamity for them.

There are many regional, rural and remote areas in Australia that have great difficulty in gaining access to services of a resident local medical practitioner. The larger regional hospitals should be used to give these recent graduates the training they need to gain registration.

State government scholarships for such training were available in the mid-20th Century and were an excellent way of training recent graduates who, when they attained registration, were then committed to practice in rural and remote areas as a condition of being awarded a scholarship.

These are just some of the problems faced by medical professionals that HPARA is trying to overcome. 

You can support HPARA by donating to its GoFundMe page.

Don Kane MB BS (UQ), FRACP, FCCP is Chairman, Health Professionals Australia Reform Association (HPARA).

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