Ahpra agrees to leave fee relief

The rebate applies to all forms of protected leave, including disability and carers’ leave.

AMA Victoria President Dr Jill Tomlinson gathered almost 3,800 signatures on a petition that stated: 

“Ahpra must operate a fair and equitable fee setting policy to enable a flexible and responsive health workforce. Failing to provide reduced fees for practitioners on parental leave shows that Ahpra doesn't 'walk the walk' when it comes to principles of equity.” 

Previously, Ahpra and the Medical Board did not offer reduced registration fees during periods of extended or parental leave. There is no reduction in registration fees for practitioners who work part-time, or for those who are on reduced incomes or under significant financial hardship. 

“This is not simply unjust (because only those who can afford to pay will stay registered, while others drop out), but inefficient. A practitioner who is not seeing patients poses a much lower risk and consequently much lower costs to regulate,” Dr Tomlinson said. 

Ahpra does provide “non-practising registration” for practitioners on extended leave, but Dr Tomlinson argued this is not fit-for-purpose for those on parental leave, due to a restrictive and complex re-registration process. 

“Non-practising registration removes practitioners’ ability to engage in any work activities — such as locum shifts or ‘keeping in touch’ days. It also burdens practitioners with significant re-registration delays of weeks to months,” she said. 

On the news today that Ahpra agreed to the rebate, Dr Tomlinson responded: 
“I welcome Ahpra’s efforts to introduce equity for practitioners on parental leave and with legally protected attributes including parental or carer responsibilities, and disability.

“It’s notable that the review Ahpra has conducted does not consider the principles of equity more broadly, and is limited only to legally protected attributes. Consideration of practitioner income levels would deliver a more equitable approach, and a more fulsome achievement in embedding the principles of equity and providing for a flexible workforce. Such an approach is used widely within medicolegal indemnity, although income is not the only measure considered by those organisations in premium determination; risk is also relevant. I am hopeful that Ahpra’s next project will address these broader considerations.

“A retrospective rebate in the registration period after leave is not the most desirable long-term approach to fee relief but it appears that this approach is being used because Ahpra currently doesn’t have the capability to offer a pro rata approach. I welcome Ahpra’s acknowledgement that a pro rata approach “may improve the practitioner experience with fees”. The quantum of 30 per cent is proportionately low where the bar is a period of leave of at least 50 per cent, but could be 100 per cent, of the duration of the prior registration year.”

Dr Tomlinson called for:

• the 30 per cent retrospective rebate to only be an interim measure while Ahpra undertakes further work to embed the principles of equity in its fee setting arrangments
• Ahpra to commit to implementing pro rata fees once it develops the capability
• Ahpra to commit to developing the capability and providing an implementation timeline
• Ahpra to document clear guidelines for staff and practitioners of the intended and appropriate purposes of non-practising registration, as non-practising registration is not fit for purpose as an option for registration during parental leave.