COAG NATIONAL REGISTRATION AND ACCREDITATION SCHEME (NRAS) FOR THE HEALTH PROFESSIONS

Dear Colleague

The AMA supports the principle of nationally consistent registration arrangements that ensure that those doctors who are qualified and safe can work anywhere in Australia.

The AMA will continue to lobby governments to convince them that these objectives can be achieved without compromising patient safety and without creating the expensive cumbersome bureaucracy of the COAG NRAS scheme.

WE CAN ACHIEVE A NATIONAL SYSTEM OF REGISTRATION WITH A SIMPLE ALTERNATIVE

THE SOLUTION

The AMA recommends that the government should:

1. maintain internationally recognised independent accreditation arrangements for medical education and training and keep them separate from registration arrangements
2. retain state registration boards and deliver a system of national registration recognition, data base and information sharing so that doctors will register in one state and achieve national registration. Complaints management and disciplinary processes will occur at a State level
3. create a national medical board that is representative of the States that will ensure state registration boards progress to harmonise the detail and application of registration for a national system.

This model protects patients. This model secures standards and the quality and safety of patient care. It keeps Australian accreditation recognized internationally. It is streamlined and cost effective.

THE PROBLEM

The proposed COAG scheme for National Registration and Accreditation passes absolute control of Australian medical standards to government and bureaucrats.

When it is introduced, it will give politicians ultimate authority over accreditation standards for medical education and training courses. Ministers will also have final approval of professional standards for medical practice, and across the scope of practice of ten health professions, with no recourse to appeal.

If we allow this legislation to proceed as is, we believe that it will lower the bar on health standards across the country and put patients at risk. This scheme will allow ministers to decide on the scopes of practice and competencies of health professions, potentially exchanging standards and qualifications for the expediency of “service delivery”.

The AMA has made clear its broad and specific objections through a number of comprehensive submissions to Government. We are pleased to acknowledge the strong position that the Colleges hold with the AMA, in relation to the continuing recognition of their role in specialist registration and the essential maintenance of the independence of accreditation from government.

• The COAG scheme underpins the Ministers ability to put workforce and budgetary political imperatives above high medical standards. This puts patients at risk by undermining the primary goal of safety and quality of care. For example, politicians could address workforce or budgetary shortages by expanding the scope of practice of other health providers, without medical, parliamentary or public scrutiny; Standards of Medical and Surgical training could be lowered to deliver “fast tracked” specialists of lower experience and skill.
• This scheme does not increase the protection of patients from “rogue” doctors and it will not secure high standards of registration of the medical profession. It will instead allow registration in areas of need for doctors who do not meet registration standards, exposing patients to risk and potential disasters in the system.
• Removal of the independence from government of the accreditation of medical education and training could mean that Australia will no longer meet international guidelines for accreditation and will put international recognition of Australian accredited courses at significant risk. The Productivity Commission recommended accreditation and registration remain separate; but the COAG scheme flies against this recommendation.
• There is no recognition, and no guarantee, of the ongoing role of the Colleges in training, conferring specialist qualifications, continuing competence and professional development and in the assessment of overseas medical graduates with specialist qualifications; It will be open to Ministerial and government direction to allow a myriad of providers, with varying standards, to undertake some of these roles and to shift scopes of practice across health professions.
• The COAG system is complex, cumbersome, bureaucratic and expensive. It will result in significant increases in registration fees for the profession, and high costs to the States for its implementation

The AMA will continue to fight for the right model of National Registration and for the continuation of the independence of our National Accreditation system. The COAG model puts Australia at greater risk of lowered standards and patient harm.

Please spread the word. Lobby your local member and State Health Minister. Do it now. The time frame is crucial and your voice adds to the energy for change for a better system of national registration for the medical profession.