Unregulated health professionals

In the past couple of years, people like Belle Gibson and Stephen Dank have received significant media attention due to allegations of inappropriate conduct in the provision of a health service.

They are not registered health practitioners that fall within the reach of the Australian Health Practitioner Regulation Agency (AHPRA) and the 14 associated national boards, so there has not been much that can be done about their purported conduct.

The provision of botox in beauty clinics, which is a prescription only Schedule 4 poison regulated by the Department of Drugs and Poisons Regulation, is also a burgeoning industry.

Other growing trends include the use of oxygen therapy in hyperbaric chambers for people with advanced and terminal cancer, or the use of vitamin C injections for the same cohort.  Largely such treatments are provided by untrained, unqualified people in the community, for considerable cost.

Other health service providers that are unregulated have also often raised concerns for the community in the areas of social work, naturopathy and nutrition, counselling and psychotherapy.

Finally, the Victorian Government has taken steps to try to regulated these areas, by introducing the Health Complaints Bill 2016.

The bill proposes the introduction of a new statutory entity called the Health Complaints Commissioner, which will replace the existing Health Services Commissioner.  The bill introduces new powers which give the new Health Complaints Commissioner power to take action against previously untouchable unregistered general health service providers who pose a risk to the community.

The bill allows anyone to make a complaint to the new Health Complaints Commissioner, which includes consumers, their families or carers, or other health service staff and members of the public.  The new Health Complaints Commissioner would also have an own motion power to investigate matters that are of a public health concern.

The new Health Complaints Commissioner retains the existing conciliation function, but will also be given new powers to ensure that providers make quality improvements they promised to undertake as part of the resolution of a complaint.  Any health service provider who fails to cooperate with the Commissioner’s process, can be publicly named and shamed.

The bill also introduces a statutory code of conduct for unregistered health service providers, a capacity to investigate breaches of the code and a capacity to prohibit certain practices, or place conditions on the practice of an unregistered health service provider.

The new Health Complaints Commissioner will have powers to issue public warnings to alert the community about risks to health, safety or welfare of persons or the public, arising from the provision of a health service.

The bill defines a health service very broadly to include:

• activities which assess, predict, maintain or improve the person’s physical, mental or psychological health or status, including prescribing medication or an activity that claims to cure autism;
• diagnosing, preventing or treating a person’s suspected or actual illness, injury or disability;
• a health related disability, palliative care or aged care service;
• surgical or related service;
• prescribing or dispensing of a drug or medicinal preparation or an aid or piece of equipment for therapeutic use;
• health education services;
• therapeutic counselling and psychotherapy services, including gay conversion therapy; and
• support services necessary to implement any of the above services.

The new regime will work alongside the existing statutory regime which governs AHPRA and the 14 national health practitioner boards to extend the reach of health service regulation in Australia and will have power over former registered health practitioners, who may continue to practise in areas similar to their former areas of practice, for example where former doctors may now be working in wellness or where former midwives might be working as doulas.

If passed, the legislation will come into effect on 1 February 2017.