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HEALTH PROFESSIONALS BILL 2003
Legislative Assembly for the Australian Capital
Territory
Health Professionals Bill 2003
EXPLANATORY STATEMENT
OVERVIEW OF HEALTH PROFESSIONALS BILL
2003
The aim of this Bill is to consolidate and update
the existing legislation relating to the regulation of health professionals in
the ACT. In doing this it is intended that this Bill provide enhanced
protection for the ACT community.
Although the existing
legislative approach has contributed to the ACT’s high standard of health
practice there have been concerns about the legislation’s ability to
effectively respond to contemporary consumer protection concerns. There have
also been concerns that the legislation is falling behind the requirements of
professional regulation in other jurisdictions.
While the Bill
seeks to retain a high level of health professional involvement in their own
regulation, it also introduces new levels of expectation in relation to the
rigour and transparency of Board decision-making. The Bill also recognises that
there should be an increased focus on community standards within board process.
The Bill seeks to increase the involvement of the community through a number of
measures. These include an increased potential for Ministerial scrutiny,
enhanced links with the Community and Health Services Complaints Commissioner,
community representation on boards and panels, and an expectation that boards
will engage the community both in terms of professional standards development
and in terms of educating the community on the professional standards they
should expect.
One of the major advances of the Bill is the
development of the ACT Health Tribunal to hear serious misconduct and appeal
matters. A magistrate will chair this body and he or she will support increased
independence and community confidence in health professional inquiry matters.
To achieve the aim of the Bill, the Bill proposes to deal with the
following key matters:
a) The repeal of existing Acts relating to
the registration and regulation of health professionals and their replacement by
this Bill and associated Regulations. Acts and Regulations to be repealed
are:
Ø Medical Practitioners Act
1930.
Ø Nurses Act
1988.
Ø Dentists Act
1931.
Ø Chiropractors and Osteopaths Act
1983.
Ø Optometrists Act
1956.
Ø Pharmacy Act
1931.
Ø Physiotherapists Act
1977.
Ø Podiatrists Act
1994.
Ø Psychologists Act
1994.
Ø Dental Technicians and Dental
Prosthetists Act 1988.
Ø Health Professions Boards (Procedures)
Act 1980.
Ø Health Professions Boards Act
1981.
Ø
Medical Practitioners (Advertising) Regulations 1985.
b) Revising
the existing health professional boards structure and operation to provide for
their enhanced role in community protection through
–
Ø requiring all boards to have community
representation within their membership;
Ø providing for greater efficiency and
effectiveness of health boards through permitting boards to represent more than
one registered health profession;
Ø clarifying and
extending the role of health boards in relation to registering health
professionals, setting required standards of practice for health professionals,
ensuring that health professionals continue to meet practice standards for the
profession and taking action in relation to reports and complaints about health
professionals;
Ø providing guidance on the assessment of
applications to become a registered health
profession;
Ø introducing obligations on health boards
to exercise their functions diligently and providing for the Minister to take
actions in relating to a non-performing board;
and
Ø clarifying the operational status of
health profession boards.
c) Providing for the operation of a Health
Professions Tribunal as a body to both assess serious complaints and reports
about the standard of practice of a health professional and to review decisions
of a health profession council. Empowering the health professions tribunal to
take action in relation to a health professional’s registration including
sole power to suspend or cancel registration.
d) Confirming in the Bill
that it is an offence to pretend to be registered in a regulated
profession.
e) Introducing the term ‘required standard of
practice’ and defining it within the Bill as the exercise of professional
judgement, knowledge, skill and conduct at a level that maintains public
protection and safety.
f) Introducing the concept
of reporting to encourage, the reporting of behaviour of registered health
professionals that breaches, or may breach the required standard of practice.
g) Ensuring that processes established by this Bill in respect of
reports are consistent with those processes in place for the management of
complaints under the Community and Health Services Complaints Act
1993.
h) Requiring that reports or complaints
about registered health professionals be jointly considered and managed by the
Community and Health Services Complaints Commissioner and the relevant health
profession board.
i) Providing for emergency orders to be made if it is
necessary or desirable to make an emergency order to protect the public or the
wellbeing of the health professional.
j) Prescribing that a health
profession board may establish personal assessment panels and professional
standards panels to assist in dealing with complaints or reports about
registered health professionals.
k) Personal assessment panels may
receive reports or complaints about health professionals where it is indicated
that a health professional’s mental or physical health or both may be
affecting a health professional’s ability to meet the required standard of
practice, and the professional may be rehabilitated. Recommendations made by a
personal assessment panel require the endorsement of the relevant health
professional board.
l) Professional assessment panels are empowered to
inquire into reports or complaints that a registered health professional has
breached or is breaching the required standard of practice of the profession.
The Bill provides that a professional assessment panel may make decisions and
take action in relation to a health professional as if the actions and decisions
were those of the health profession board. A professional assessment panel does
not have power to cancel or suspend a health professional’s
registration.
m) Protecting people who have made a report or people who
have participated in proceedings from civil or criminal
liability.
HEALTH PROFESSIONALS BILL
2003
PART 1 – INTRODUCTORY
Clause 1. Name of Act - If passed the Bill will become the
Health Professionals Act 2003. The title indicates that the provisions
apply to all health professionals who are registered in the
Territory.
Clause 2. Commencement – Provides that the Bill
commences on a date fixed by notification by the Minister and advertised in the
Gazette. Different dates may be set for the commencement of different
provisions within the Bill. Facility for graduated commencement is provided to
enable health boards to adopt the revised powers and processes stemming from the
enactment of this legislation.
If the Bill has not commenced within one year
then clause 2(2) commences it.
Clause 3. Dictionary
– Certain words and expressions used in the Bill are defined in the
dictionary set out at the end of the Bill. A definition found in the dictionary
applies to the use of words in the entire Bill unless another meaning applies in
a particular part of the Bill.
Clause 4. Notes –
Within the Bill notes are used to assist in the understanding of particular
provisions. The notes themselves are for explanation purposes only and do not
form part of the Bill.
Clause 5. Offences Against Act- Other
legislation applies in relation to offences against this Act. The Criminal Code
applies to all offences against this Act.
PART 2 – WHAT DOES THIS ACT DO
Clause 6. Outlines – Part 2 of the Bill is provided
as a guide for people in relation to the intended operation and application of
the Act. The Bill extensively revises the existing laws related to prescribed
health professions. This part is an important support in understanding and
identifying the revised laws.
Clause 7. Regulation of health
professionals – This section identifies that the Bill establishes a
system for the registration of certain health professions. The health
professions this Bill applies to are those that the Executive Governments under
Part 4 of the Bill decides should be regulated.
The Bill requires that
health boards continue to administer the process of health professional
regulation. The responsibilities exercised by a health professional board
include –
1. registering health professionals in
professions;
2. setting the required standard of practice for the
profession;
3. ensuring health professionals continue to meet the required
standard of practice; and
4. taking action in relation to reports or
complaints about health professionals.
The Bill establishes a body to be
known as the health professions tribunal to consider and/or act on matters
relevant to a health professional’s practise that may lead to the
suspension or cancellation of a health professional’s registration. The
tribunal may also hear appeals about decisions of health boards.
To
operate effectively the Bill requires persons who practise in prescribed health
professions to be registered. Penalties exist within the Bill for unregistered
persons who provide health services in regulated professions.
Clause
8. How does a health professional’s behaviour come to a health profession
board’s attention? – The Bill provides that a health profession
board is informed about a health professional’s behaviour through either
–
1. someone making a report under this Bill;
2. a complaint being
made under the Community and Health Services Complaints Act 1993; or
3. a report is made following the review of a health professional’s
performance.
Clause 9. Reports – The Bill introduces the
concept of reporting as an additional way people may express concerns about the
standard of practice or suitability to practise of a health professional. The
use of the term report is intended to allow for the expression of concern
without involving issues of blame, liability or settlement.
To effect
appropriate management of a report the Bill introduces a requirement that each
report is to be jointly considered by the relevant board and Community and
Health Services Complaints Commissioner.
Where a report indicates that a
health professional’s mental or physical health is affecting their ability
to meet the required standard of practice or satisfy the suitability to practise
requirements the Bill provides for a matter to be considered by a personal
assessment panel. Health profession boards establish such panels under part 12
of the Bill.
If a report concerns the health professional’s
standard of practice, or if a report has not been successfully dealt with by a
personal assessment panel, then a board can consider the report through a body
it establishes as a professional standards panel.
Clause
10. Personal assessment panel – The Bill supports the appropriate use
of personal assessment panels as a pro-active and cooperative approach to the
review of concerns about a health professional’s mental and physical
health in relation to the meeting of the required standard of practice. Matters
that go before a personal assessment panel do so with or without the agreement
of the health professional. The health professional may choose whether they
will participate in a panel assessment. The health professional’s
agreement is required if the panel recommends to the board that a condition be
placed on the health professional’s registration. Where a health
professional does not agree to the recommendation of a personal assessment panel
the absence of agreement is noted in the referral of the recommendation to the
health profession board for possible further action under part 11 of the Bill.
Clause 11. Professional standards panel – The Bill provides
for the board to establish a professional standards panel as a body empowered to
review and take action where a health professional has breached a standard of
practice requirement or does not satisfy suitability to practise requirements.
The professional standards panel has certain powers to deal with matters
however these powers do not include action to suspend or cancel a health
professional’s registration. Only the health professions tribunal
exercises these latter powers.
Clause 12. Interaction with Community
and Health Services Complaints Act – The Bill requires that the
Community and Health Services Complaints Commissioner consult with the relevant
health profession board whenever he or she receives a report or complaint about
a registered health professional. Such consultation is intended to commit the
parties to a joint decision about how to deal with a report or complaint. Where
a joint decision cannot be reached then the most serious of the actions proposed
by either the health profession board or the commissioner is to be given effect
to.
The Bill overall seeks to provide a more flexible system of
dealing with reports and complaints than is provided for under the current
law.
PART 3 – MAIN OBJECT AND IMPORTANT
CONCEPTS
This part sets out that the main object of the Bill, the steps detailed
within the Bill to assist achieve the object and the key concepts that underpin
the application and operation of the Bill.
Clause 13. Main Object -
The Bill provides that the object of the Bill is to protect the public from
risk of harm through ensuring that health professionals regulated by the Act are
competent to provide health services and that they attain and keep up the
required standard of practice. The Bill achieves this objective by
-
1. applying the provisions of the Bill to an individual health profession
if such action promotes the protection of the public;
2. providing a clear
criteria for regulating health professions;
3. establishing a system of
registration of health professionals including providing for the issue of
practising certificates for continuing registration;
4. providing for a
system that continuously reviews the standard of practice of health
professionals;
5. providing boards with appropriate powers to administer the
provisions of the Bill in respect of one or more health
professions;
6. providing an accessible structure through which the public
may report concerns about the competence of health professionals;
7. putting
in place a structure and system for the management of reports about a health
professional’s breach of the required standard of practice or failure to
satisfy the suitability to practise requirements;
8. establishing a system
for dealing with health professionals who are found to be breaching or to have
breached the required standard of practice or the competence to practise
requirements; and
9. providing for the establishment and operation of a
health professions tribunal.
Clause 14. Who is a health
professional? – This provision defines what is meant when the term
‘health professional’ is used within the Bill. A health
professional is a person who provides a health service while working in a health
profession.
Clause 15. What is a health service? – A
health service is referred to within the Bill as being a service provided by a
person for the purposes of -
1. assessing, recording, maintaining or improving the physical, mental, or
emotional health, comfort or wellbeing of the service user;
2. diagnosing or
treating an illness, disability, disorder or condition of the service
user.
This explanation has been adapted from a definition of a
‘health service’ that appears in the Health Records (Privacy and
Access) Act 1997.
Clause 16. What is a regulated health
service? – The term regulated health service means a health service
usually provided by a health professional in a regulated health profession.
Clause 17. When is someone a registered health professional?
– A person is considered to be registered when they have been granted
registration under requirements and standards applying to a profession as set
out under this Act. People whose registration is suspended are considered to be
registered for the purposes of action being taken under this Act. People whose
registration is suspended may not however actively practice as a registered
health professional (see Part 8 Offences).
Clause 18. What is the
required standard of practice? – The required standard of practice is
a phrase used throughout the Bill and refers to the exercise of a health
professional’s judgement, knowledge, skill and conduct at a level that
maintains public protection and safety.
This provision provides that
regulations made under the Act may prescribe particular behaviours that do and
do not meet the required standards of practice. The regulations do not however
limit what behaviour does or does not meet the required standard of practice.
The Bill clarifies that where standards of practise operating under this
Bill are inconsistent with standards that may be developed under the
Community and Health Services Complaints Act 1993, the latter standards
have precedence.
Clause 19. What is the relevant health profession
board? – The Bill provides clarification of the use of the phrase
relevant health profession board where it is used in relation to a health
professional.
PART 4 REGULATION OF HEALTH PROFESSIONS
Clause 20. Decision to regulate health profession
– The Bill provides that the Executive may, in writing, recommend that
a health profession be regulated. The Executive may make such a recommendation
on its own initiative or on behalf of a body or person who the Executive
considers acts on behalf of the applicant profession.
Before the Executive makes a recommendation under this part it needs to
be of the opinion that it is both necessary and desirable to register the
applicant profession.
Any notice of decision to register a health
profession is a disallowable instrument.
Clause 21. Deciding whether regulation necessary or
desirable – In order to assesses how necessary and desirable it is to
register a health profession the Executive is required to give reference to the
following considerations –
1. the potential for harm and the likely extent of harm to the health and
safety of the public if the profession is not provided properly;
2. if the
quality of health services provided to the public will be improved as a result
of the profession being regulated;
3. if the profession could operate
effectively in a non-regulatory environment; and
4. whether the profession
can be regulated.
In order to assess if a profession can be regulated the
Executive must consider if –
1. the profession has a distinct area of
practice; and
2. there is an objective basis for assessing the competence of
members and potential members of the profession; and
3. if significant
training and education is needed to become a competent member of the
profession.
The Executive may consider other relevant matters in deciding
whether to register a profession.
Clause 22. How may the regulations
regulate health professions – A health profession becomes regulated
through the approval of a regulation under the Act. The Executive can approve
such a regulation. A regulation may make provision in relation to anything that
the executive is given power to regulate under the Act. Matters that are either
necessary or convenient for regulating the professions may also be set out in
the regulations. The regulation establishing the profession as a regulated
profession must also –
1. contain a statement of the general area of
operation of the profession. It is intended that this statement will be
informative and identify by way of statement the general activities undertaken
by persons registered in the profession;
2. the requirements that a health
professional needs to satisfy in order to be considered suitable to practise in
the profession.
Clause 23. Suitability to practise requirements
– People seeking to practise in a regulated health profession need to
demonstrate their suitability to practise. The relevant health professional
regulation must set out the suitability requirements for a person who applies to
be unconditionally registered in a particular profession. The regulations must
set out –
1. qualification requirements; and
2. requirements about
mental and physical health;
3. requirements for admission to a specialty area
(if any) within the profession; and
4. requirements in relation to the
maintenance and demonstration of continuing competency, recency of practice and
professional development.
PART 5 HEALTH PROFESSION BOARDS
Division 5.1 Establishment and function of
boards
Clause 24. Establishment of Health Profession Boards –
In order to give effect to the regulation of a profession the regulations must
establish a health professions board in relation to a health profession.
The regulations are required to establish certain provisions in relation
to a particular health board. These provisions include –
1. the size of
a board and its composition, including the number of community members it is to
have and whether or how many members are appointed or elected;
2. if any
members are elected, how elections are to take place;
3. reference to at
least one community representative being appointed to each health board; and
4. reference to any requirement that a community representative be a member
of another profession (such as a member of the legal
profession).
Clause 25. Number of health profession boards –
The Bill requires that there be only one health profession board for a
particular health profession. There may therefore not be two boards that
register, for example, nurses. More than one profession may however share a
health board. There could be for example an allied health profession board.
The regulations may also require two or more health professions to form a single
health board. Where a health board regulates more than one health profession
there must be representation of at least one member of each health profession on
the health profession board.
Clause 26. What do health profession
boards do? – The role of a health professional Board is to assist the
Minister with the administration of the Act. The health professional Board is
given specific functions including the following –
1. administering a
scheme of registration and a scheme to continually review the standard of
practice of registered health professionals;
2. setting fees for activities
administered by the board;
3. giving advice to the Minister, profession and
public about matters relevant to the profession;
4. setting standards of
practice for the profession;
5. participating in the activities of a body
that is responsible for the development of national policies for the maintenance
of standards of practice within the profession or within regulated health
professions generally;
6. approving educational and training courses related
to professional qualifications;
7. promoting and monitoring the continuing
competence of relevant registered health professionals and promoting and
monitoring their professional development;
8. dealing with registered
professionals who are not competent to practise, or who may breach a required
standard of practice;
9. providing information to enable the laying of
charges against people who commit offences against the Act;
10. assisting in
the development of the required standard of practice;
11. promoting the
required standard of practice;
12. developing and promoting the required
standards of practice;
13. developing supportive relationships with
individuals and bodies that have a shared interest in public protection and
health professional regulation;
14. providing information to confirm whether
or not someone is a registered professional.
The activities of a health
profession board are limited by restrictions on their capacity to cancel or
suspend the registration of a health professional. A board may only suspend or
cancel registration when acting on the direction of a health professions
tribunal. .
Clause 27. Obligation to exercise functions
diligently – The Bill requires a health professional board to
diligently exercise its functions.
Clause 28. Reporting on exercise of
functions – The Bill provides that the Minister, in writing, may
request that a health professional board provide a report about the exercise of
its functions. The request may be for a general report or may be for a report
on stated criteria or matter. The health professions board must respond in
writing to the Minister within the time set by the Minister which must be
reasonable in the circumstances.
Clause 29. Failure by health
profession board to exercise functions diligently – Health profession
boards are entrusted with significant roles in relation to public protection.
Where a board fails to perform their functions appropriately as required by the
Bill or regulations than the Minister has an obligation to take action on such
matters. The Bill provides certain powers to the Minister responsible where he
or she is satisfied that the health professional board is not exercising its
functions diligently. The Minister may in writing advise the board of his or
her concerns and provide a further explanation of why he or she is not
satisfied. The time period for the health profession board to respond to the
Minister will be set out in the Minister’s notice however it must allow a
minimum of 14 days.
The Minister may consider any representations from
the health profession board on the issue. If the Minister remains dissatisfied
that the health profession board is not exercising its functions diligently than
he or she may write to the board to tell them what they are to do to conduct
themselves diligently.
The Minister may be guided in his or her
assessment of the diligence of a board by reference to the functions of board
set out within the Act. The Minister may or must also take into account any
matter set out in regulations regarding to the functions of a
board.
Clause 30. Discharging health profession board - After
giving the board written notice, and after a reasonable time has passed the
Minister may advise the board of why he or she is not satisfied that the board
is exercising its functions diligently. The Minister may also provide the board
a minimum of 14 days to provide reasons why it should not be discharged.
After considering any representations from a health professions board
the Minister may ask the Legislative Assembly to approve the discharge of a
health board. The Legislative Assembly may agree to such action by the passing
of a resolution. The Bill provides that if the Legislative Assembly approves
the discharge of a health profession board the discharge is given effect by the
Minister writing to the board.
Clause 31. Effect of discharge-interim
Board – If action has been completed to discharge a health profession
board the Minister may appoint health professionals to an interim health
profession board if the Minister is satisfied that the person has the experience
to exercise the functions required of a board member. An appointment is for 6
months only and may not be extended. The period of 6 months is to permit the
necessary arrangements to be made to appoint a replacement board including the
calling of nominations and the fulfilment of electoral processes if
required.
Division 5.2 Status and Powers of health profession
boards
Clause 32. Legal status of health profession board
– The Bill provides that a health professional board has the usual
characteristics of a corporation.
This provision provides amongst other matters certainty about the
status of a health profession board. In particular it clarifies that board
conduct is independent of other agency decision-making and supports the existing
practise of Boards managing their independent business affairs.
Clause 33. Banking and investment of money of board –
Health boards must-
1. maintain one or more accounts with a deposit
taking institution; and
2. pay all monies received into an accounts;
and
3. pay all amounts it spends out of an account.
The health
professional board can also invest its money in a manner that it considers
appropriate.
The Legislation Act 2001 defines what is meant
by an authorised deposit taking institution.
Clause 34. Prohibition of
business – Members of board must not knowingly agree to a health
profession board engaging in business that is outside of its
functions.
Clause 35. Borrowing power – The Bill permits a
health profession board, following an unopposed resolution, to
1. Borrow
money required for the exercise of its functions;
2. Secure repayment of any
amount borrowed and the payment of interest on the borrowed amount.
An
unopposed resolution means a resolution that no one votes against and there is
at least one vote in favour of the resolution.
Clause 36. Community
representative list – The Bill provides for one or more community
representatives to be appointed as members of a health professions board. To
facilitate this community representation, the board is to maintain a list of
persons who are suitable to represent community interests in relation to the
health profession. The Bill requires that the Minister endorse the list in
writing. The list is a notifiable instrument.
PART 6 REGULATION OF HEALTH
PROFESSIONALS
Division 6.1 Registration of health
professionals
Clause 37. Who may be registered as a health professional?
– The health profession board for a health profession is required to
register or renew the registration of a person (or a corporation should the
regulations allow a corporation to be registered in the health profession) as a
health professional if the health board is satisfied that –
1. the
person satisfies the suitability to practise requirements for the profession;
and
2. the persons (individual applicants or individuals who may be providing
health services on behalf of the corporation) knowledge of written and spoken
English is adequate to allow the person to practice in the profession;
and
3. the person is covered by insurance (if any) required by the
regulations.
In assessing a health professional’s application for
registration or re-registration a health board may register a person with
conditions placed on their registration or register a person unconditionally.
Not withstanding that a person has met the general requirements for registration
as set out in the Act, the regulations may prescribe profession specific
requirements for registration that may mean a person does not meet the
requirements for unconditional registration.
The health professional
regulation may also be prescriptive in terms of details of –
1. what an
application for registration must contain and how it must be made;
and
2. when a person is taken to be suitable to practise in the health
profession; and
3. when someone may be registered conditionally,
and
4. when the health professional board may apply to the health
professions tribunal for the suspension or cancellation of
registration.
The regulations may also set out when a health
professional’s registration may be renewed (for example, annually on a
particular date) or the requirements if a registration is renewed
retrospectively.
Division 6.2 Performance reviews – The
Bill provides that in addition to examining a health professional’s
initial suitability for registration a health profession board has a role
in the oversighting the application of a health professional’s
professional practice.
Clause 38 Review of health professionals
professional practice -Health profession boards may review a health
professional’s professional practice in circumstances where either
–
1. the health professional agrees; or
2. the health professional has been required to take part in a review by a
health professions tribunal or by a professional standards panel.
Health
Boards are agents of government and persons who are engaged by a board to review
a health professional’s practice act on behalf of the board. The reviewer
of a health professionals practice may do so by asking the health profession
questions, by requiring the health professional to undergo a test or by
reviewing the health professionals clinical records. It is intended that any
inquiry conducted in relation to the health professional’s clinical
records complies with relevant Privacy legislation.
Clause 39. Initial
and final review reports - The Bill requires that the person who
conducts a review of a health professionals professional practice must prepare
an initial report on the results of the review, and give a copy of the review to
the health professional. The reviewer must also give written notice to the
health professional that they have 30 days in which to respond to the report.
After considering the health professional’s response the reviewer
is to prepare a written report and give a copy to the health professional and
relevant health board. The health professional board may or may not choose to
consider the report as a breach of a required standard of practice.
PART 7 HEALTH PROFESSIONAL TRIBUNAL
Division 7.1 Health professions tribunal
Clause 40. Establishment and functions of health
profession tribunal – The Bill provides for the establishment of the
Australian Capital Territory Health Professions Tribunal. The tribunal is a new
entity that functions to bring independent judgement and scrutiny to
applications concerning registered health professionals. Matters to be
considered by the tribunal include-
1. applications
made to the tribunal for decision about whether a registered health professional
has met the required standard of practice or satisfies the suitability to
practise requirements. Usually such matters would involve serious public
protection concerns and may if established lead to the health
professional’s registration being suspended or cancelled. Matters of
lesser seriousness would in most circumstances be dealt with by a health
profession board through its panel system;
2. the making of emergency orders if required;
3. to hear
applications to review a decision of health profession boards and
professional standard panels;
4.to answer questions of law referred to the
health profession tribunal by health
profession boards.
The Bill
permits other functions to be given to the health professions tribunal by the
Bill or by any other law of the Territory.
Clause 41. Appointment of tribunal president
– The Executive Government may appoint a person who is a magistrate to be
president of the health professions tribunal. An appointment under this clause
is for 5 years and the appointment is subject to scrutiny as a notifiable
instrument.
Clause 42. How is a health professions tribunal panel made up?
A health profession tribunal panel is formed by the health professions tribunal
president and 3 members nominated under clause 43 of the Bill.
A health
professions tribunal panel is formed to hear an application about a matter
relating to a registered health professional. The panel may hear more than one
matter relating to health professions in that profession. The Bill also
establishes circumstances where the health tribunal president may act alone.
Clause 43. Nomination of panel members - The Bill provides that
where an application to a health professions tribunal is made about a health
professional the tribunal president must ask the relevant health professions
board to provide panel members. The health professions board is to nominate 3
panel members of whom -
1. 2 must be health professionals, with one of these
health professionals being from the same health profession as the health
professional to which the application relates. Such health professional
participation is considered to provide enhanced knowledge within the panel of
professional standards of practice and competence to practise requirements;
and
2. 1 must be a community representative. Community representation
supports
enhanced consideration of public protection aspects of an
application.
To ensure an appropriate nomination of a health professional
to a health professions tribunal panel the Bill permits the health professional
to be draw from either the ACT or elsewhere.
The health professions
board is to nominate the community representative from the community
representative list that it maintains under the Act.
Where a suitable
health professions tribunal panel is in existence the health professions
tribunal president need not call from fresh nominations from the health
professions board.
Clause 44. When may president alone constitute
health profession tribunal? – The Bill permits that in certain
circumstances it will be expedient and appropriate for the health profession
tribunal president to consider matters alone. The functions that a health
profession tribunal president may perform while sitting alone include
–
1. an application by a health profession board for an interim or
emergency order about a health professional’s registration;
2. an
application from a health profession board for directions on how to proceed in
relation to a report or a complaint about a health professional;
3. a matter
that is admitted or not contested or in relation to a matter where the parties
have agreed to an approach;
4. a matter where the relevant parties agree to
the president exercising his or her powers alone;
5. an application that a
hearing, or part hearing, be closed
6. conducting a preliminary hearing into
a matter under clause 58.
A fully constituted tribunal panel must hear
matters that are outside of the above functions.
Clause
45. Registrar – The Bill provides that the registrar of the
Magistrates Court is to be the registrar of the health professions
tribunal. The registrar acts under the direction of the health professions
tribunal president.
Division 7.2 Applications to health professions
tribunal
Clause 46. Application to health professions tribunal for review
– The Bill establishes that an application for review may be made to a
health professions tribunal in respect of a decision of a health professions
board to –
1. to register or not register a person;
2. to register a
person conditionally;
3. to register a person for less than 1 year;
4. to
impose conditions or refuse to impose conditions on a person’s
registration.
A health professions tribunal may also review a decision of
a health profession board’s professional standards panel that a person has
breached the required standard of practice or competence to practice
requirements. The tribunal may in addition review any other decision relating
to powers exercised by a board under the regulations to this
Bill.
Applications for review of a decision of a health professions board
may be made by a person directly affected by the decision or anyone else with
the leave of the health professions tribunal.
Clause 47. How to make
an application – Under the Bill an application to the health
professions tribunal is made by filing a written application with the tribunal.
Where an application is in respect of a matter set out in clause 46 of the Bill
the application must be made within 28 days of the health professional receiving
notice of the health profession board’s decision. The Bill however allows
the health professions tribunal discretion to extend the time in which an
application can be made.
Clause 48. Parties to proceeding
– The Bill sets out that the parties to a proceeding on an application
relating to a decision about a person include-
1. the person;
2. the
health profession board that made the decision or the board that established the
professional standard panel that made the decision;
3. any one else with
leave of the health professions tribunal.
Clause 49. Referral to panel by
tribunal – The Bill provides the health professions tribunal with
facility to refer an application or part of an application for consideration by
a panel established by a health profession board. The health professions board
may prepare a report on its consideration of the matter and refer its report
back to the tribunal. The tribunal has power to adopt the board’s report
as its own or it may adopt a decision made in a report as its own decision in
respect to an application.
Division 7.3 Tribunal proceedings
Clause 50. Time and place of proceedings - The Bill provides
that the tribunal president decides the times and places that a
health tribunal will sit.
Clause 51. Notice of hearing – The
Bill requires that the health professions tribunal president give notice of the
intention to hear an application to the parties to the proceeding on the
application. At least one month’s notice of a hearing is to be provided
to the parties.
Clause 52. Hearing usually in public – The
Bill provides that most applications or inquiry into applications that proceed
before a health professions tribunal are to be open to the public. In
circumstances prescribed by clause 53 a tribunal hearing or part of a hearing
may be closed to the public.
Clause 53. Closed hearings in special
circumstances – In the interests of justice or where it is otherwise
in the public interest a health profession’s tribunal may –
1. order that a hearing or part of a hearing is to be held in private and
give directions about the people who may be present at a restricted
hearing;
2. direct that evidence including documentation given at either a
public or private hearing be subject to publication prohibitions or
restrictions.
3. direct the non-disclosure or restriction of disclosure of
evidence or documents to one or more parties to a proceeding.
Persons
who contravene this clause without reasonable excuse may be subject to
penalty.
Clause 54. Evidence - In order to permit the efficient
hearing of a matter the Bill does not restrict a health professions tribunal to
the rules of evidence. A tribunal must however ensure that it conducts itself
within the expectations of natural justice.
Clause 55. Procedures
- The Bill provides that where procedural guidance is not provided within
the Act or within other law the health professions tribunal may decide its own
procedures. Procedures followed by the tribunal should be simple and quick and
observe natural justice.
Clause 56. Natural justice – The
Bill requires the health professions tribunal to observe natural justice in all
its operations.
Clause 57. Representation before tribunal - The
Bill permits parties to a proceeding before a health professions tribunal to
appear personally or to be represented by another person. Parties may be
represented by a lawyer.
Clause 58. Preliminary hearing –
The Bill provides that a tribunal president may conduct a preliminary
hearing to decide matters that are preliminary to application. The tribunal
president may do one or more of the following at a preliminary hearing
–
1. make orders for the conduct of a hearing of the
application;
2. require parties to make discover or permit inspection of
evidentiary material;
3. require parties to file pleadings;
4. strike out
an application on the basis that it is frivolous or vexatious.
During a
preliminary hearing a tribunal president may also give instructions that a
matter may be suitably referred to a health board’s personal assessment
panel or professional standards panel. The tribunal president may also give
instructions about the matters that should be considered or done by a health
board panel. This provision facilitates both the efficient handling of matters
and also provides an opportunity for the tribunal president to provide support
for the activities of a health board panel.
Clause 59. Powers in
relation to witnesses etc – The Bill states that a tribunal president
or a person authorised in writing by the president may require a person to
appear before the tribunal and give evidence or produce specified documents.
Notice under this clause is to be provided in writing.
Persons who are
required by notice to attend a tribunal must do so and must attend until excused
by the health professions tribunal president. A specified penalty may be
applied to persons who breach this provision.
The Tribunal president has
the option of taking evidence under oath or by affirmation. The president also
has power to require a witness to a hearing to answer a question or to produce a
document or anything else that is relevant to a hearing. The Bill provides that
persons who fail to take an oath or make an affirmation or persons who fail to
give evidence may be subject to penalty.
Clause 60. Adjournment
– The Bill supports reasonable action by the health profession’s
tribunal to adjourn proceedings at any point considered appropriate.
Clause 61. Interim and Emergency Orders – The Bill empowers
the health professions tribunal to make an interim or emergency order where
–
a) it is requested to make an interim or emergency order and the
Tribunal
considers such action to be in the public interest or the
wellbeing of the health
professional; or
b) it considers an interim
or emergency order to be appropriate prior to an
adjournment of
proceedings.
An interim or emergency order that is made when a
proceeding is adjourned generally ends when a final order is made at the end of
a tribunal proceeding. The health professions tribunal may however determine an
earlier end to an interim or emergency order.
An interim or emergency
order that is made in respect to an application is valid for the period stated
in the order but may not be in force for more than 3 months. The tribunal may
however renew an interim or emergency order for one further period of 3 months.
The intent of this time limitation is to encourage the early resolution of
proceedings.
Clause 62. Decision without inquiry – The Bill
provides for certain matters to be dealt with expeditiously. A health
professions tribunal may decide to give a decision on a matter without holding
an inquiry hearing. Circumstances where action under this provision may occur
include where a health professional agrees that they have been; contravening or
have contravened a required standard of practice; does not satisfy the
suitability to practice requirements; or does not have the insurance (if any)
required under the regulations. The health professions tribunal is however to
be satisfied, prior to making a decision under this provision, that it has
considered representations made about the matter, that the public interest has
been satisfied and that it has sufficient information upon which to base its
decision. The health professions tribunal must give written notice to parties
to the proceeding that they have 21 days to make representations about the
tribunal’s intention to make a decision without an
inquiry.
Clause 63. Decisions of tribunal – The Bill
provides that a decision of a tribunal panel is the decision about which the
majority of the panel members agree. Where there is no majority agreement then
the decision of the health tribunal president becomes the decision of the
tribunal panel.
Clause 64. Orders tribunal may make – The
Bill provides that a health professions tribunal may make one or more of the
following orders in relation to a registered health professional
–
1. counsel, caution or reprimand the person;
2. require the
person to undergo stated medical, psychiatric, or psychological assessment,
counselling or both;
3. impose on the person’s registration any
condition that the tribunal considers appropriate to protect the
public;
4. require the person to take part in a review of the persons
clinical practice;
5. require the person to complete a stated educational or
other stated professional development course;
6. require the person to report
on the person’s practice at stated times, in the way stated, and to a
named person;
7. require the person to seek and take advice from a stated
entity about the management of the person’s practice;
8. require the
supervision, monitoring or reporting about the affect of something the person is
required to do by the tribunal;
9. accept a voluntary undertaking from the
person;
10. require the relevant health professional board to suspend the
persons registration for a stated period;
11. cancel the person’s
registration;
12. if the person is not registered – declare that, if
the person had been registered, the tribunal would have found that the person
contravened a required standard of practice, or did not satisfy the suitability
to practise requirements. (this provision allows a tribunal to take action in
respect to a person who was previously registered as a health professional.
Circumstances may exist where the persons standard of practice as a registered
health professional was such that an order to protect the public is required in
the event that they should again seek to practise as a registered health
professional.)
The tribunal may also make any other order it considers
are appropriate. As soon as practical the tribunal is to give written notice of
an order to the parties to a proceeding. The tribunal may give notice of an
order to any one else with a legitimate interest in the proceedings that it
considers appropriate.
Clause 65. Notice of decision –
Notice of a decision of the tribunal is to be known as the decision notice. The
decision notice is to contain an explanation of the reasons for the
tribunal’s decision. Certain information may be omitted from the notice
if the tribunal considers that it is not in the interests of a person or is not
necessary or desirable in the public interest. Where a decision is taken to
omit information than the decision notice must contain a statement to this
effect.
Clause 66. Referral of questions of law to Supreme Court
– The Bill provides that the health professions tribunal can, on its own
application or on behalf of a party to a proceeding, make an application to the
Supreme Court to obtain guidance on a matter of law. When an application is
made to the court the tribunal cannot act in a manner that presupposes the
court’s judgement. The tribunal can also not act contrary to a decision
that is made by the court.
Clause 67. Appeals to Supreme Court – The
Bill directs that a party to a hearing of a health professions tribunal may
appeal to the Supreme Court about a decision of the tribunal.
Clause 68. Disrupting etc a health professions tribunal – A
person who either at a health professions tribunal or within the hearing of the
tribunal does any of the following, may be subject to penalty
–
1. threaten, disturb or insult the health professions
tribunal;
2. interrupt, interfere with or obstruct proceedings of the
tribunal; or
3. commit any other act that is a wilful contempt of the
tribunal.
Clause 69. Approved forms – The Bill provides that
a tribunal may in writing approve forms for particular purposes. Approved forms
are a notifiable instrument.
PART 8 - OFFENCES
Clause 70. Meaning of registered for pt 8 – For part 8 a
person is not registered, if the person’s registration is
suspended.
Clause 71. Offence to pretend registration –It is
an offence under this Bill for a person to pretend that they are registered as a
health professional when they are not currently registered under this Act. This
provision supports one of the fundamental public protection principles of the
Bill. Requiring standards to be met by those who operate as registered health
professionals protects the public.
Clause 72. Provision of regulated health service by
unregistered people – This provision provides that a person is not to
provide, as part of their business, a regulated health service to a person in
the ACT unless they are registered as a health professional. A person commits an
offence if they intentionally do so and the person is not registered in a health
profession. A regulated health service is defined in the Bill as a service
ordinarily provided by a health professional who belongs to a regulated health
profession.
This provision does not apply in certain circumstances where
–
1. a health service is provided in an emergency. For example where a
person who is registered in a health profession in another State or Territory
provides a health service in the ACT during an event that is recognised as an
emergency;
2. where a person who is registered in a health profession in
another State or Territory is in the ACT solely for the purposes of body organ
retrieval or removal for purposes associated most commonly with
transplantation;
3. where a person who is registered in a health
profession in another State or Territory acts as a health escort to a person
being transported in or out of the territory; or
4. the provision, by
mail order, or over the Internet or by other electronic
means, of
manufactured aids to rehabilitation, surgical prosthetics and
orthotics
or pharmaceuticals; or
4. where the health service provided is one that
is ordinarily a service provided by a profession that is not subject to
regulation under this Act.
It is not intended that the restrictions under
this provision apply to the conduct of business or activities of persons who
supply, via a mail order system, rehabilitation aids, prosthetic aids and
orthotics aids, or pharmaceuticals.
Clause 73. Conditions on
practice – Where a person has a condition placed on their registration
a registered health professional commits an offence if he or she knowingly
provides a regulated health service in contravention of that condition. This
provision applies if the condition has been placed on the person’s
registration in the ACT or under similar laws that apply in another
jurisdiction.
Clause 74. Change of registered details – In
order that action may be taken to protect the public a health board needs to
have access to current access information on each person registered in the
profession. This provision requires that a registered health professional
promptly advise in writing the relevant board of any change to their name or
address. Failure to do so within the specified period constitutes an offence.
Clause 75. No insurance – The bill provides that if a
health professional is required to have insurance and they cease to have this
insurance they must inform the relevant health professional board as soon as
practical. Failure to inform constitutes an offence.
PART 9 REPORTING
Division 9.1 Object of pt 9
Clause 76. Object of Pt
9 – Part 9 encourages the reporting of a registered health
professional’s behaviour where such behaviour contravenes or may have
contravened a required standard of practice, or does not satisfy the suitability
to practise requirements. The purposes of reporting are both to promote action
being taken to protect the public and to effect a scheme of early intervention
in terms of rehabilitation or retraining for the health professional concerned.
The term ‘report’ has been used to separate protective action under
this Act from schemes involving health complaints. The latter complaint schemes
may more broadly involve negligent conduct or systemic issues and may also
involve settlement and fault. Reporting is intended to be a largely pro-active
process related only to registered health professionals and unrelated to dispute
resolution.
Division 9.2 Reporting
Clause 77. Meaning of registered health professional for div 9.2
– Under this part the term-registered health professional refers to a
person who is or was registered at the time an action or omission occurred.
Clause 78. Who may report? Any one may report if they have a
reasonable believe that a registered health professional may have been
contravening or have contravened a required standard of practice or does not
satisfy the suitability to practise requirements. Persons, who as a result of
their occupation gain information that constitutes a report, such as officers of
the court or a police officer are included in the definition of persons who may
make a report.
Clause 79. Who may report be given to? – It
is intended that a report could either be made to a health profession board or
to the Community and Health Service Complaints Commissioner. The Commissioner
will perform the function of register of all reports and accordingly the health
board is required to give a copy of any report to the Commissioner.
Clause 80. False or misleading report – Persons who provide
a false or misleading report may be penalised under the Act.
Clause
81. How must a report be made? – The Bill intends that the legitimacy
of a report be encouraged through requiring reports to be in writing, to be
signed and to include details of the reporter’s name and address. Where a
reporter does not comply with these requirements the health board or
commissioner may still take action on the report (this legislative requirement
has been adopted from the formal process for the making of a complaint under the
Community and Health Services Complaints Act 2002) however the Bill
permits the Minister to make guidelines for exercise by the relevant board in
relation to this matter. The Community and Health Services Complaints
Commissioner or the health board has, by exception, power to accept a verbal
report. Guidelines are a disallowable instrument and must be notified.
Clause 82. Help in making a report – The Bill permits
the Community and Health Services Complaints Commissioner or an executive
officer of a health profession board to assist some one prepares a written
report.
Clause 83. Further information about reports – The
Bill provides that a health profession board can seek additional information and
confirmation in relation to a report including requiring a report to be attested
to by the making of a statutory declaration. The Bill requires that the board
set a reasonable time period for this requirement to be met. (note: the
Community and Health Services Complaints Act 1993 gives similar powers to
the commissioner)
If the reporter does not comply with a request to provide
information in the form of a statutory declaration the report may still be made
but a board is not bound to take action in relation to the report.
Clause 84. Notice to health professional reported – The
Bill requires that where a report is made about a health professional in a
regulated profession the relevant health profession board or the Community and
Health Services Complaints Commissioner must tell the health professional
concerned. The form of advice must be in writing, and it must provide
information in relation to the general terms of the report and the intention of
board and the commissioner to consider the report. The advice to the health
professional should also contain the name of the person making the report unless
it is considered that the provisions of clause129 of this Bill apply. The
provisions of clause 129 of the Bill are derived from section 27 of the
Community and Health Services Complaints Act 1993. Section 27 of the
latter Act prevents the Commissioner from giving the provider information in
circumstances where the Commissioner considers that the disclosure might
–
• put someone’s health or safety at risk;
or
• cause some one to be provided with a community service or health
service of a lower standard than the person would otherwise have received;
or
• prejudice the assessment of a report or an investigation by the
commissioner.
Where the commissioner stops believing that the above
circumstances apply, the commissioner must provide the
information.
PART 10 – JOINT CONSIDERATION WITH
COMMISSIONER
The intent of this part is to prescribe joint consideration of a report
between the Community and Health Services Complaints Commissioner and the
relevant health board.
Clause 85. What does pt 10 apply to – The
bill provides that certain matters will be jointly considered by the Community
and Health Services Complaints Commissioner. Such matters include –
1. a report or complaint that the relevant health professional board
considers indicates that a health professional may be contravening or have
contravened a required standard of practice or does not satisfy the suitability
to practise requirements;
2. a report or complaint that has been considered
by a boards personal standards panel and the board considers that the matter now
indicates a breach of standard of practice;
3. where a board rejects the
recommendations of a board’s personal standards panel and the board
considers that a health professional has breached or is likely to breach the
required standard of practice;
4. a professional standards panel refers a
matter back to board because the panel considers the report or complaint to have
been inappropriately referred to it.
Clause 86. Consultation with the commissioner etc
– the Bill provides that a health professional board must consult with
the Community and Health Services Complaints Commissioner in relation to matters
dealt with in part 10. The relevant board must also seek to make joint
decisions with the commissioner in relation to matters dealt with under this
part.
Where a jointly agreed decision cannot be made than the most serious
action proposed by either the board or the commissioner must be
followed.
Decision on actions to be taken in respect to a matter
considered under part 10 are as follows. The actions are listed from most
serious to least serious –
1. make an application to the tribunal for
an emergency order under part 11 of the Bill;
2. refer the matter to the
health professions tribunal;
3. refer the matter for investigation by the
Community and Health Service Commissioner;
4. refer the health professional
to a professional standards committee of board;
5. refer the health
professional to a personal assessment panel of board;
6. if the matter is a
complaint refer the matter for conciliation under the Community and Health
Services Complaints Act 1993;
7. refuse to investigate the matter
further.
If a complaint or report indicates that the health professional
may have committed an offence against a law of the Territory than board may
provide information to the chief police officer.
The Bill does not
restrict a board from only taking a series of actions on a
matter.
Clause 87. Indication that offence committed – The
Bill provides that if a complaint or report indicates that an offence against
another Territory law has occurred then the board may give police a copy of the
report or complaint. The board may however continue to take action on a matter
that it has reported to police.
PART 11 – PERSONAL ASSESSMENT
PANELS
A personal assessment panel is a panel that a board may establish
as a means to hear a matter concerning a health professional’s mental or
physical health. The panel is prescribed as a less formal forum that has a
rehabilitation focus. Most matters addressed by the panel will take place with
the consent of the health professional involved. A personal assessment panel
does not make decisions in its own right but recommends actions for a health
professions board’s consideration.
Division 11.1 Establishment
and Purpose
Clause 88. Establishment of personal assessment
panel - The Bill provides that a board may establish one or more personal
assessment panels. A board may refer a report or a complaint to a personal
assessment panel if -
1. the report, complaint or review suggests that the
state of a health professionals mental health or physical health, or both, are
affecting the professionals competence to practise; and
2. the board is
satisfied that there are grounds for believing that the health professional may
be rehabilitated.
The bill requires that a health board refer a report or
a complaint to a personal assessment panel if required to do so under the
Community and Health Services Complaints Act.
Clause 89. Referral of
application by health professions tribunal – The Bill establishes that
where a health professions tribunal refers an application or part of an
application to a personal assessment panel a board is obliged make such a
referral. In such circumstances the panel is required to inquire into the
matter as if it was a report and to report back to the tribunal. The panels
report to the tribunal may include a recommendation that is the same type of
recommendation that a panel can make to a health board under clause 98. The
panel may alternatively recommend that the health professional be counselled.
The Bill further provides that a panel could report that it cannot make an
appropriate recommendation.
Clause 90. What does a personal assessment
panel do? – the Bill provides that the role of a personal assessment
panel is to –
1. assess whether the mental or physical health or both,
of a registered health professional are affecting the health
professional’s ability to meet the required standard of practice or
suitability to practise requirements; and
2. if the panel is satisfied that
the health professional’s mental or physical health, or both, are
affecting the professionals ability to meet the required standard of practice,
or the suitability to practise – decides whether and how the professional
may be rehabilitated.
A personal assessment panel also considers
applications to review conditions on registration that may have been imposed as
a result of a panel’s recommendation. A personal assessment panel cannot
assess a report or complaint on its own motion.
Clause 91. Who must be on
a personal assessment panel? – The Bill provides that a personal
assessment panel is appointed by a health professions board and consists of 3
members. At least one member of the panel must be a registered health
professional but may be registered in another jurisdiction. The Bill does not
require that the health professional be registered in the same health profession
as the board is responsible for.
The Bill seeks to ensure that a broad
non-health professional view of the report or complaint is considered by
providing that one member of the panel is not to be a registered health
professional. The bill also supports that members of the panel may be draw both
from the ACT or elsewhere. The health professions board is to appoint one
member of the panel as the panel chairperson.
Division
11.2 Assessments by personal assessment panels
Clause 92. Natural
justice – The Bill provides that the panel must observe natural
justice.
Clause 93. Assessment by personal assessment panel
– The Bill allows a panel to consider information that is available to
it including the report or complaint, any other information provided by the
Community and health Services Complaints Commissioner or person who made the
report and any other relevant information collected by the panel.
The
personal assessment panel is also obliged consider information provided by the
health professional.
Clause 94. Powers of personal assessment panel on
inquiry – The Bill requires that a personal assessment panel must
–
1. endeavour to talk to the health professional about the report,
complaint or application;
2. give the health professional an opportunity to
respond to information given to the panel;
3. consider whether the health
professional is contravening the required standard of practice;
4. if
satisfied if their was a contravention – consider whether the breach was
caused, or contributed by to, by the health professional’s mental or
physical health.
To assist the panel the Bill provides that a panel may
make enquires or obtain information from anywhere appropriate. The panel may
also require that a health professional undergo a medical, psychiatric or
psychological examination or test. Where such a test is performed the board
meets the cost of the initial
examination or test.
Clause
95. Legal representation before personal assessment panel – The Bill
intends that matters before a panel be non-adversarial. The Bill provides that a
lawyer may represent a person before a personal assessment panel.
Clause
96. How does a personal assessment panel reach a decision? – The Bill
provides that the agreed decision of a majority of panel members is the decision
of the panel. If however the panel cannot reach a majority decision than the
decision of the panel chairperson is the decision of the panel.
Clause
97. Action of personal assessment panel after inquiry – The Bill
provides that following an inquiry the personal assessment panel may with the
agreement of the health professional concerned do 1 or more of the following
–
1. counsel the health professional;
2. recommend that the health
professional attend counselling or a rehabilitative program;
3. recommend to
the health professional board that they take no further action in relation to
the health professional;
4. recommend to the board that the board accept a
voluntary undertaking from the health professional;
5. recommend that a
stated condition be placed on the health professional’s registration by
the health board.
The personal assessment panel’s recommendation to
a board may include a recommendation that a health professional attend a named
counsellor or program. The panel may also recommend that a panel review a
health professional’s registration or a condition placed on registration,
at a particular time.
If a panel considers that it has no appropriate
action available to it than it does not need to take action under this
section.
Clause 98. Inappropriate referral to personal assessment
panel – The Bill provides that a personal assessment panel may refer a
matter back to board if the panel is of the view that the matter was
inappropriately referred to them.
Clause 99. Referral to board –
Where a personal assessment panel has considered a matter the Bill requires
that the panel report back to the health professional board that originally
considered the matter with the following information –
1. the
information obtained by the panel;
2. a description of the assessment of the
health professional;
3. what the panel decided to do and why;
and
4. whether the health professional agreed to the action proposed to be
taken to the panel.
Division 11.3 Action by Board after inquiry by
personal assessment panel
Clause 100. Board consideration of
referral by personal assessment panel – The Bill provides that where a
personal assessment panel has referred a report to a health professional, Board
must consider the report and decide what to do.
If the board considers
that the health professional has, or may be contravening a standard of practice
then it must take the matter back for consideration of appropriate action with
the Community and Health Services Complaints Commissioner or apply to the
tribunal for an emergency order if satisfied this is necessary
Unless
this is a matter for further review with the commissioner, board may
–
1. Take action under clause 102;
2. refer the matter to a
professional standards panel;
3. refer the matter to the Community and Health
Services Complaints Commissioner for further investigation;
4. ask the
health professional tribunal to suspend or cancel the health
professional’s registration;
5. ask the health professional tribunal to
take any other appropriate action;
6. take no further action.
.
Clause 101. Acceptance of condition – The Bill provides that
where a personal assessment panel has recommended that a condition be placed on
a health professional’s registration and the health professional has
agreed a board may take such action.
Clause 102. Decision on
referred health professional – Where a health professional makes a
decision on a report from a personal assessment panel it is required to give the
health professional a notice of decision. The notice is to include an
explanation of the reasons for the decision. The board make also give written
notice of the decision to the commissioner.
Clause 103. Application
for condition review – If a decision has been placed on a health
professional’s registration the health professional may apply to have the
condition removed or changed.
Clause 104. Review of application
– The Bill provides that where an application has been received from a
health professional for a review under clause104, the board is to refer the
matter to a personal assessment panel. The board is where possible, to refer
the application to the panel that originally considered the matter.
The
personal assessment panel must do one of the following after considering a
review application –
1. recommend to the health professional board that
the application be granted;
2. recommend to board that the stated parts of
the application be granted or rejected;
3. recommend to board that the
application be rejected;
4. recommend that the application be reviewed by a
professional standards panel, the health tribunal or considered jointly by the
Community and Health Services Complaints Commissioner and the
board;
5. recommend that other action be taken and explain why the action is
appropriate.
Recommendations under this section by the panel must be
given to the health professions board in writing.
Clause 105. Action by
board on recommendation by personal assessment panel – The Bill
provides that where a board has accepted the recommendations of a personal
assessment panel that the health professions board is to advise the health
professional in writing and include reasons for the decision.
If the
health professions board rejects the recommendations of the panel they must make
a decision on the application and advise the health professional in writing of
the decision and the reasons for it.
If the board considers that the
application relates to whether the health professional is contravening or has
contravened the required standard of practise then it may choose to consider the
matter jointly with the Community and Health Services Complaints Commissioner.
If the board considers the matter without consultation with the commissioner
than it may tell the commissioner about the decision.
PART
12 PROFESSIONAL STANDARDS PANEL
A Professional Standards
Panel is a panel that a board may establish as a means to hear a report,
complaint or application for a condition review about a health
professional’s standard of practice. A professional standards panel
considers reports or complaints where the outcome is not one that may lead to
the suspension or removal of registration of a health professional. The
decisions of the professional standards panel are decisions of
board.
Division 12.1 Establishment of professional standards
panel
Clause 106. Establishment of professional standards
panel – The Bill provides that a health professions board may
establish 1 or more professional standards panels.
Clause 107. What
does a professional standards panel do? – Under this Bill the role of
the professional standards panel is to decide whether a registered health
professional has contravened or is contravening the required standard of
practice or fails to satisfy the suitability to practise
requirements.
The professional standards panel may consider a range of
information that is available to it, including –
1. the report or
complaint;
2. any information provided by the Community and Health Services
Complaints Commissioner, or by the person made the report or complaint;
3. any other relevant information given to the panel.
The panel must
consider information provided by the health professional before it makes any
decision under this section.
A professional assessment panel may not
consider a matter on its own motion but may only act on a matter that is the
subject of a referral to it.
Clause 108. Who must be on a professional
standards panel – The Bill provides that a professional standards
panel consists of 3 members appointed by the board. One member of the panel must
registered, either locally or in an equivalent jurisdiction, in the same
profession as the health professional to be considered by the panel. At least
one member of the panel must not be a registered health professional. Panel
members may be drawn from the ACT or elsewhere.
The health professions
board is to appoint one member as the panel chairperson. A panel may be
constituted to consider one individual matter about a health professional or it
may be a panel established by board to consider all such professional standards
matters.
Clause 109. Referral of application by health professions
tribunal – The Bill provides that a board must refer an application or
part of an application to a professional standards panel if required to do so by
a health profession tribunal. The professional assessment panel must conduct an
inquiry into such applications that have been referred to it as if the matter
was a report. It is however not appropriate in these circumstances that the
panel exercises its powers to make an interim order under clause 119.
After the professional standards panel considers an application it must
provide a report to the tribunal. The panel’s report may recommend that
the tribunal take any of the actions that the panel could make under clause123
of the Bill.
If the panel is unable to make an appropriate recommendation
to the tribunal then it must state this fact to the tribunal.
Division
12.2 Inquiries by professional standards panels
Clause 110. When
may professional standards panel choose not to inquire? – The Bill
provides that where a health professional admits to a matter, a professional
standards panel may consider that it is appropriate to make a decision without
the need for an inquiry.
Clause 111. How does a professional
standards panel reach a decision? – Decisions of a professional
standards panel are the decisions about which a majority of the panel
agrees. Where a panel is unable to reach a majority decision than the decision
of the panel is the decision of the panel chairperson.
Clause
112. Inappropriate referral to professional standards panel – The Bill
provides that a panel may refer a matter back to a board when it considers that
the original referral of the matter was inappropriate. An inappropriate
referral may be made in circumstances where –
1. the panel believes on
reasonable grounds that the report or complaint if substantiated may provide
grounds for suspension or cancellation of a persons registration;
2. the
panel considers that the matter should appropriately be considered by a personal
assessment panel; or
3. the panel considers that emergency action is
necessary.
Where a matter is referred back to the board as an inappropriate
referral than board is to consider the referral jointly with the Community and
Health Services Complaints Commissioner.
Division 12.3 Procedural
requirements for inquiry hearings
Clause 113. Setting inquiry
hearing times – If a matter is referred to a health professional
standards panel the panel must set a time for holding an inquiry about a health
professional. The Bill also requires that at least 1 month before the hearing
day the panel give written notice of the hearing time and place to the health
professional, the relevant health professions board and the Community and Health
Services Complaints Commissioner. The panel may also give notice of the inquiry
to the person who made the report or complaint.
Clause 114. Conduct of
inquiry hearing – The Bill provides that a professional standards
panel can conduct a hearing in any way it considers fit. The panel is required
however to observe natural justice.
Clause 115. Inquiry by
professional standards panel – The Bill permits a standards panel to
make inquires and obtain any information it needs to decide a matter before it.
The panel has power in this regard to arrange for a performance review to be
conducted of a health professional’s practise. The panel need not confine
itself to a review of one incident but may also consider information relating to
the pattern of practice of a health professional.
Clause 116. Role
of commissioner – The Bill provides that the Community and Health
Services Complaints Commissioner may give evidence about an assessment or an
investigation that he or she has conducted in respect to a report or complaint.
The Bill further permits the Commissioner to be present at a professional
standards panel hearing even though he or she is not giving
evidence.
Clause 117. Inquiry hearings closed – Inquiry
hearings will normally be closed to the public. The Bill however
provides that a professional standards panel may direct that a hearing be open
to the public if the benefits of an open hearing outweigh the disadvantages to
the health professional concerned.
Clause 118. Interim
actions– The Bill provides that a professional standards panel may
take action under clause 123 (2) on an interim basis prior to the finalisation
of a hearing. Action taken of an interim nature is to be based on a need to
protect the public. An interim decision has effect until the panel reaches its
final decision.
Clause 119. Adjournment – A standards panel
may adjourn an inquiry if such action is appropriate. The Bill however provides
that a decision to adjourn a matter should be balanced by the desirability to
deal with matters promptly.
Clause 120. Representation at professional
standards panel inquiry hearing – The Bill provides that persons
specified may be accompanied at a standards panel inquiry by a legal adviser or
other support person. Specified persons include –
1. the health
professional;
2. the Community and Health Services Commissioner;
3. a
witness that is permitted by the panel to attend the inquiry.
The Bill
intends that a professional standards panel be conducted in a manner that is as
non-adversarial as possible. The panel will also in most instances be conducted
in the first person. Where the panel is of the view that special circumstances
exist they may agree to a person being represented by a lawyer or other support
person.
Clause 121. Record of standards inquiry – The Bill
requires that a professional standards panel must keep a record of a standards
inquiry.
Clause 122. Action of professional standards panel after
inquiry – The Bill provides that a decision of a professional
standards panel involves consideration of –
1. if the health
professional has contravened or is contravening the required standard of
practice or fails to satisfy the suitability to practise requirements; or
2. if the health professional has or is otherwise putting or has put public
safety at risk.
Where a professional standards committee is satisfied
that a health professional has breached the requirements or put public safety at
risk the panel may do one or more of the following –
1. counsel,
caution or reprimand the health professional;
2. require the health
professional to undergo stated medical, psychiatric or psychological assessment,
counselling or both;
3. impose on the health professionals registration a
condition that the panel considers appropriate to protect the
public;
4. require the health professional to take part in a review of the
health professionals clinical practice;
5. require the health professional to
complete a stated professional development course;
6. require the health
professional to report on the professional’s practice at stated times, in
a way stated and to a named person;
7. require that the health professional
seek and take advice from stated entities in relation to the management of the
professionals practice;
8. require the supervision, monitoring or reporting
about the affect of something the health professional is required to do by the
panel;
9. refer the report, complaint or application for conditions review,
along with standard inquiry report, to the health professions
tribunal;
10. accept a stated voluntary undertaking from the health
professional.
If the professional standards committee acts in the above
ways then the action is an act of the health professions board.
Clause
123. Inquiry report – The Bill requires that a professional standards
panel will, as soon as practical after finishing a standards inquiry, prepare a
written report that includes the following information;
1. if the panel
decides that the health professional contravened or is contravening the required
standard of practice or fails to satisfy the suitability to practise
requirements – how the requirements were contravened;
2. whether there
is, or was a risk to the public from the health professional’s practise
and what the risk is or was;
3. the action taken by the panel and reasons for
the action.
The Bill requires that the panel, within 28 days of the end
of a standards inquiry, will give the standards inquiry report to
–
1. the health professional; and
2. the health professional board
that established the panel; and
3. the Community and Health Services
Complaints Commissioner.
The panel may also give the report to any one
else that it considers appropriate. The panel may however omit from a copy of
the report material in order to protect someone’s
confidentiality.
Clause 124. Publication of standards inquiry
report – A standards inquiry is conducted in the public interest and
therefore the Bill requires a professional standards panel to publish a
standards inquiry report. The Bill provides however that a panel may omit
material, including the name of the health professional, from a copy of the
report if there is reasonable grounds that the public interest is not served by
including the material. If through omitting material the report is not readily
understood the panel may publish a summary of the report.
PART
13 PROTECTION AND INFORMATION
This part provides for the protection
of persons and information from action or disclosure in circumstances that
support the protective intent of the legislation.
Clause 125. Meaning
of informed person for pt 13 – The Bill provides for the use and
definition of the term ‘informed person’ where a person is or has
been –
1. a member of a health profession board; or
2. a member of
the health profession tribunal; or
3. a member of a personal assessment panel
or a professional standards panel; or
4. a member of the staff of a health
profession board; or
5. acting under the direction or authority of a health
profession board; or
6. a member of the staff of the health profession
tribunal; or
7. acting under the direction or authority of the health
professions tribunal; or
8. providing advice or expertise to the health
profession tribunal.
Clause 126. Protection of participants and people
reporting – the Bill provides that an action cannot be taken against
certain persons to whom this section applies in relation to an act done or
omitted to be done where they have acted honestly. The Bill prescribes these
persons as being a person who is or has been a participant in a proceeding about
a report, a complaint or an application for a standards review before a health
board, a personal assessment panel; a professional standards panel, the health
professions tribunal. This section also protects the person who made a
report.
Clause 127. Protection of informed person
– The Bill provides that a person who is an informed person under the
Act does not incur civil or criminal liability for anything done or not done by
the person acting honestly and without negligence for the Act.
The Bill further provides that if a civil liability arises then this is
a liability of the ACT and not the informed person.
Clause
128. Non-disclosure of reports - The Bill contains a fundamental provision
in relation to the protection of persons who make a report. This provision has
been developed from the Community and Health Services Complaints Act
1993. Persons in the category of persons referred to in clause 126 as being
‘informed persons’ must not disclose information to a health
professional that permits the reporter to be identified where this would –
1. put at risk the health or safety of anyone; or
2. cause anyone to
receive a lower standard of health service than the person would have received
if the reporter had not been identified; or
3. prejudice the management of
the report or an investigation by the Community and Health Services Complaints
Commissioner or health profession board.
Clause
129. Secrecy– The Bill provides a general restriction on the
unauthorised divulging or recording of information. A breach of confidentiality
and proper use of information may place at risk both an individuals privacy and
public confidence in the operation of the legislation.
The Bill
prohibits an informed person from directly or indirectly making a record of, or
divulging, communicating or producing to anyone, protected information about
another person where the informed person has acquired the information because
they are an informed person.
The Bill provides that the above
prohibitions do not apply if the informed person makes the record or divulges or
communicates the information in the exercise of a function of the person under
this Act or law of the ACT.
An informed person may also divulge or
communicate protected information -
1. with the consent of the person from
whom the information was obtained from; or
2. to a person administering or
enforcing corresponding law in a local jurisdiction; or
3. to a law
enforcement authority.
The Bill further provides that an informed person
need not divulge or communicate protected information to a court or produce a
document that contains protected information to a court, unless it is necessary
to do so for this Act or another Act.
PART 14 MISCELLANEOUS
Clause 130. Exemptions from Act-The Minister may exempt
individuals from a provision of this Act if satisfied that public interest is
served by doing so.
Clause 131. Cost of supervising protective action
– The Bill provides that a Board may charge a health professional a fee or
require the health professional to pay reasonable costs associated with
monitoring compliance with a condition or requirement on their
registration.
Clause 132. Determination of fees by board –
The Bill permits a health profession board to determine and apply
fees to certain of its activities. Fees established by a health profession
board apply only to the health profession the board regulates. A health board
is required to notify under the Legislation Act 2001 any fee
determination. A fee determination may be disallowed by the Legislative
Assembly.
Clause 133. Determination of fees by Minister - The Minister
may determine fees for this Act excluding fees in relation to a health
professional board. The Minister’s fee determinations most be notified
and the notice is a notifiable instrument.
Clause
134. Regulation-making power – The Bill provides for the Executive to
have a general regulation making power in relation to the Act. This regulation
power includes the making of regulations that impose conditions, including
restrictions, on the practice of a health professional. Regulations may also
apply, adopt or incorporate an instrument such that it may be applied in full or
in part in the ACT. Before making such regulations the Executive is to be
satisfied that the conditions are necessary to protect the public or are in the
public interest.
PART 15 TRANSITIONAL PROVISIONS
Transitional provisions are provided under this Part to facilitate the
orderly and lawful transfer of powers and obligations from existing health
professional legislation to the revised legislation.
Clause
135. Definition for pt 15 – To interpret this part certain terms need
to be understood. These terms are –
board means a board
established under a former act.
commencement day means the day the
former Act that related to a profession is repealed.
Repealed act
means an Act repealed under clause 147.
Clause 136. Repeals - The
individual Acts that applied to specific health professions are repealed by the
introduction of this Bill. Acts that applied to Health Profession Board
activities are also repealed by this act. The repealed Acts are –
• Chiropractors and Osteopaths Act 1983
A1983-28
• Dental Technicians and dental Prosthetists
Registration Act 1988 A1988-85
• Dentists Act 1931
A1931-8
• Health Professions Boards (Elections) Act 1980
A1980-45
• Health professions Boards (Procedures) Act 1981
A1981-46
• Medical Practitioners Act 1930
A1930-13
• Nurses Act 1988 A1988-61
• Optometrist
Act 1956 A1956-54
• Pharmacy Act 1931
A1931-10
• Physiotherapist Act 1977
A1977-60
• Podiatrist Act 1994
A1994-82
• Psychologist Act 1994 A1994-87
Clause
137. Professions to be regulated - The Bill provides that health professions
that were regulated under an Act set out in clause137 will continue to be
registered under the revised Act. This Executive decision to continue to
regulate these professions under these transitional provisions is not a decision
that may be disallowed.
Clause 138. What happens to registration under
repealed Acts? – If a person was registered as a health professional
under a former Act immediately before this Act was commenced than they are taken
to be registered under this Act. Unless a persons registration is cancelled or
otherwise ends earlier their registration continues to the date of expiry that
applied under the relevant repealed Act.
Clause 139. Conditional registration – If a person was
registered under a former Act and their registration was subject to conditions
these conditions continue to apply under this Act. The conditions apply till
registration ends for the first time under this Act or the condition is amended
or removed under this Act. This section applies in circumstances even where the
condition could not be imposed under this Act.
Clause 140. What about
unfinished board inquiry under repealed Acts? – Where a board has an
inquiry in progress immediately before the commencement of this Act and the
inquiry is not finished the inquiry is to be treated as a report under this Act.
Clause 141. What about board orders under repealed Acts?- If a
board ordered a person to do something and the order is not completed prior to
the commencement date the person is required to complete the order under this
Act. Failure of a person to complete the order is to be taken as a
contravention of this Act.
Clause 142. What about suspensions under
repealed Acts? – If a person’s registration was suspended
immediately before the commencement day the suspension continues under this Act.
The suspension continues in force for the period established under the former
Act. Such a suspension cannot be extended however a health board may take
action to suspend a person’s registration under this Act.
Clause 143. Suspension or cancellation under repealed Acts
– If a person’s registration has been cancelled or suspended by
a board this cancellation or suspension may be considered if the person submits
an application for registration or re-registration under this Act.
Clause
144. What about current board fines under repealed Acts? – If a person
has not paid a fine imposed under a former act prior to the commencement of this
Act the person is required to pay the fine within the time period that was
previously established. Failure to pay the fine within the time stated is taken
as a contravention of this Act.
Clause 145. What about past board
fines under repealed Acts? – The Bill provides that a person is to be
taken as being in breach of this Act if they do not pay a fine imposed under a
former Act where the fine expires not longer that one month before commencement
day.
Clause 146. What about appeals from board decision?
– If a person had a right to appeal a board decision immediately
before the commencement day this right is not affected by the repeal of the
former Act. If the body that hears the appeal refers the matter back to the
decision-maker then the referral is to the relevant health profession
board.
Clause 147. Vesting of assets and liabilities of Territory in
health profession board? – The Bill empowers the Minister to make a
declaration by which specified assets, rights or liabilities may be vested to
particular health professions. This provision facilitates the orderly transfer
of matters and assets that the Territory has nominally owned on behalf of the
boards. Under the revised legislation the entities known as a health profession
boards may be given sole responsibility for the assets, rights or liabilities.
Any declaration under this section is a notifiable instrument.
Clause
148. Registration of changes in title to certain assets – This
provision supports the vesting of assets under Clause 149. The responsible
representative of the Territory is required to register the transfer of assets
to a health profession board.
Clause 149. Proceedings and
evidence in relation to vested assets and liabilities – The Bill
provides that if an action could or had begun in relation to a vested asset or
liability prior to its transfer to a health professions board the board
subsequently becomes a party to proceedings instead of the Territory.
Proceedings in relation to a vested asset or liability are subject to the
Limitations Act 1985.
Clause 150. Prerequisites for appointment
to health profession board – Transitional provisions are provided to
recognise a person’s length of registration under a repealed Act as part
of a determination of a person’s eligibility for membership of a health
profession board.
Clause 151. Transitional regulations – The
regulations may prescribe savings or transitional matters because of the
enactment of this Bill.
Clause 152. Modification of pt 15’s
operation – The Bill provides that the regulations may modify the
operation of this part.
Clause 153. Expiry of part 15 – The
Bill specifies that the transitional arrangements established under Part 15
expire two years after commencement day.
DICTIONARY
The dictionary sets out the meaning of words used in the
Bill.
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