Regulation: The Third Party in the Transformation of Patient-Professional Relations

Regulatory arrangements have the capacity to codify elements of the relationship between patients and professionals. They can articulate the expectations that patients can reasonably have of their treating health professional, and also provide a mechanism to notify and address instances where defined standards of professional practice are not met. 

 This paper reports on a project exploring the institutional design of a new national regulatory system. It draws on an analysis of government drivers for reform, including instances of regulatory failure that led to patient harm. It also incorporates analysis of key practical texts including the regulatory impact statement and the consequential legislation to explore how the reforms were designed to affect relations between patients and professionals.

 The introduction of the National Registration and Accreditation Scheme for Health Professionals in Australia in 2010 consolidated arrangements across fourteen professional groups who were previously registered separately across each of Australia’s eight jurisdictions. Each state and territory also had separate arrangements to assess the qualifications and experience of health professionals who qualified outside Australia. These new arrangements brought into place consistent requirements across continuing professional development, criminal history records, English language, insurance and recency of practice for over half a million practitioners.

 The transformative effect of ongoing consumer advocacy efforts is also reflected through the legislative requirement for community members to sit on all decision-making bodies that administer the Scheme.  Another significant outcome of the Scheme has been the provision of single register of practitioners that provides improved transparency with patients now able to directly access information about the registration status and qualifications of their health professionals.