While over 58% of GPs in Healthed’s 5 March survey haven’t formed a fixed position on the proposed amendment, nearly all of the free text comments expressed concerns, particularly about the fairness of a permanent register, as well as the potential risk of false accusations.
More than 2200 GPs gave their views:
Surveyed GPs expressed several concerns about how reforms that would require the National Boards to permanently list health practitioners who a tribunal finds guilty of sexual misconduct or boundary violations might play out.
“Whilst I do not approve of sexual misconduct, there are always three sides to every story, and I feel that errors will be made, and innocent people caught up in this,” one GP said.
“This will completely ruin the doctor’s whole life, not just their career. Sometimes we as doctors deal with some patients with really weird personalities, which could lead to some allegations,” another said.
Some noted the potential impact on family members of implicated doctors—while others questioned the need for a different standard for health professionals compared to other professionals such as lawyers, judges and politicians.
Many took a nuanced view, saying it should be decided on a case-by-case basis.
“If multiple violations and offences are present over a period of time, then yes, entire regulatory history should be listed. However, if only a single allegation or not confirmed fully guilty, then it’s not fair to the practitioner who may by some chance be actually innocent,” one surveyed GP wrote.
“If it actually proceeds, there have to be significant safeguards in relation to vexatious or very minor issues. Matters that resulted in no further action should never be published,” another GP said.
“One-rule-fits-all is a recipe for injustice in some cases… and I wonder about the likelihood of vigilante attack on some low risk and vulnerable guilty practitioners,” another GP noted.
Many GPs were particularly concerned that the listing of a practitioner would be permanent.
“It will cause permanent branding and does not ever allow for redemption or change,” one GP wrote. Others worried about the potential suicide risk.
The Medical Board of Australia has detailed information about what constitutes a boundary violation. Breaches range from engaging or seeking to engage in a sexual relationship with a patient (regardless of whether it is consensual), to sexual abuse, harassment or assault—with quite a bit in between. Behaviours that may breach sexual boundaries include a sexual relationship with someone close to a patient, or with a former patient, among others.
“Sexual misconduct and criminal sexual offence may be VERY different from ‘sexual boundary violations’ which is more likely to encompass miscommunication, misunderstanding, cultural background and differences between doctor and patient… and may benefit from education, supervision etc…” one surveyed GP commented.
“The types of complaints include inappropriate or sexualised remarks, intimate touching of a patient without consent, personal relationships where there is an imbalance of power, and aggressive sexual offending, including criminal behaviour,” Ahpra noted in its annual report last year.
In 2022-2023, Ahpra received 841 notifications about 728 registered health practitioners concerning boundary violations. Of those notifications, 361 were about medical practitioners. Overall, 129 health practitioners had matters decided in the tribunal. Last year there was a 7.9% increase in the number of practitioners referred to a tribunal by a National Board, but the overall number of GPs that will be affected by the proposed changes is reported to be small.
In its submission to the health ministers, the AMA said it supports the reform overall, but questioned the recommendation to publish a doctor’s entire disciplinary history, noting that no rationale had been provided for that.
Noting the breach of trust that shifts the balance to the patient’s right to know, the AMA said supports “the ongoing publication of the practitioner’s regulatory history in relation to all transgressions of a sexual nature including sexual boundary violations.”
“However we note that the proposed change to the National Law, in addition to the ongoing publication of a practitioner’s regulatory history relating to conduct of a sexual nature, will result in the practitioner’s entire regulatory history being published in perpetuity – not just the history relating to the sexual misconduct.”
Like surveyed GPs, the RACGP said it needed more information before deciding whether to support the proposal, asking for clarification about what would be included in the full regulatory history, and citing concerns around the indefinite nature.
“Despite our members’ support for accountability and transparency, they have expressed concern about retaining information on the public register permanently. It may be appropriate to publish information for a set period and then remove it from the register once it expires which would be a similar approach to a Spent Convictions Scheme,” the RACGP wrote in its submission.
For more information:
Proposed reforms to the Health Practitioner Regulation National Law | Engage Victoria
Choosing a new doctor? Their sexual misconduct may soon be on the record – Healthed
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