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Prior to the scheme’s introduction, there were over 80 bodies in Australia’s six states and two territories responsible for the registration of individual health practitioners and the accreditation of their education and clinical training. These were replaced with a single regulator – the Australian Health Practitioner Regulation Agency – operating under a single legislative framework. The introduction of the scheme was a significant change, and in some instances contested existing power relations between the state and health professions.
This change followed more than twenty years of inter-governmental discussions that sought to address a series of health workforce governance and management challenges. These included multiple boundary issues; standardisation of registration criteria in each state and territory within and across different health professions, ensuring consistency of criteria for the assessment of overseas-trained health practitioners, as well as underlying concerns of patient safety and management of risk to patients.
This study has utilised a range of techniques to examine the policy process that led to the establishment of the scheme, including policy mapping, historical institutionalism and problem representation analysis. The paper will describe critical events in the wider policy environment and report on the parallels with, and the influence of, whole-of-government economic reform agendas. We will canvass the integration of this policy change with other health governance mechanisms, considering how notions of safety, quality and the balance between professional responsibility and autonomy have been addressed.