National Registration and Accreditation Scheme - Changes lobbied for by the AMA

Approval processes

Ministers to approve list of specialities but only on advice from Boards which in turn must have regard to advice from the AMC or a specialist medical college;
Ministers approve registration standards (including scopes of practice) but only on advice from Boards;
Boards approve all other standards (e.g. accreditation standards, CPD);
On accreditation standards, Boards role is limited to “approving standards developed and submitted to it by the accrediting authority (AMC)” and if they don’t approve them, the legislation explicitly allows the AMC to “out” their decision;
On transition the current AMC accreditation standards will be automatically adopted under the scheme without need for approval by Ministers or by the National Board;
Neither the Board nor the Ministers can write or rewrite existing accreditation standards;
Ministers can’t unilaterally impose a particular change to accreditation standards, they can only issue directions to the Board, and in turn the Board can only refuse to approve or seek review, if they believe that the change will substantially and negatively impact on the recruitment of supply of the workforce;
Consultation required with other affected Boards (and advice to Ministers on their views) if another health professional Board is proposing changes to their scopes of practice.

Professional representation on Boards

State flexibility

State/territory Boards (committees) of the National Board can be established;
If a State Board of the National Board is established, members will be appointed by the jurisdiction Minister;
Flexible complaints handling arrangements to accommodate State preferences;
At least one representative from large and one representative from small States and Territories on National Board – no limit in the Bill to number of Board members in total, but in practice may see not all States represented on National Board.

Role of national agency vs. role of National Board

Board is on equal footing with agency in relation to resourcing decisions – agency can’t usurp Board re: resourcing;
Agency is to provide services to the Board under a mutually agreed service agreement;
Agency is not involved in registration or accreditation decisions or activity of the Board unless the Board allows it;
Each Board has separate bank account run by the agency;
Funds can only be paid out of the Board’s account if consistent with agreed Board budget or if Board approves the expenditure;
Board staff employment arrangements and ability of Board to hire/fire staff not clear.

Legal representation for registrants

Explicit right in the legislation for attendance of legal representation at hearings of professional standards panels or health panels.

Specialist registration and area of need

Specialist registration only for qualified doctors as assessed by Board (agreed recognised qualifications or substantially equivalent qualifications);
While Ministers can still determine areas of need, there is an explicit provision protecting right of Boards not to register registrants merely because they are going into an area of need.

Mandatory reporting

Mandatory reporting not required by professional indemnity employees or those involved in legal proceedings;
The definition is not as broad or onerous as has recently been proposed in Queensland.

Miscellaneous issues previously proposed which we objected to

No mandatory requirement for registrant to provide workforce data to gain or retain registration (Ministers and Board can ask for it but registrant not obliged to provide it);
No explicit link in Bill B between registration and MBS/PBS entitlement;
No further reference to “continuing competence requirements”;
No further reference to “practice requirements”;
Doctors endorsed to practice in the area of acupuncture will be able to use the title “acupuncturist”;
It will be an offence for any health professional to recklessly use the title “specialist”.

Student registration

Will be mandatory but will all be done between the educational institution and the Board;
Only relevant offences by students will be dealt with by Board (indictable offences and impairment).

Good Medical Practice: Code of Conduct for Doctors

Further to the “wins” in the Bill B set out above, the AMA has also been the prime instigator in achieving a much more acceptable draft national code of conduct for the medical profession through the AMC’s code development process over the past 12 months. This will ensure that the new National Medical Board has a workable and acceptable code of conduct to use as the basis of regulation under NRAS once the National Board is in operation.

Australian Medical Association