Shifting Ground? Government Influence in Health Professional Governance in Australia

National reform of health workforce governance was implemented in Australia in 2010 in response to a series of public safety and socio-political concerns, risks and scandals. At the core of the changes was the creation of an operational agency – the Australian Health Practitioner Regulation Agency, working alongside fourteen profession-specific National Boards. The objectives of the National Registration and Accreditation Scheme for the health professions extended beyond the traditional and expected scope of protection of the public to encompass wider concerns of workforce mobility and workforce responsiveness to healthcare needs.

This paper reports on document analysis and key informant interviews conducted in order to analyse evolution of the national scheme. We have characterised the influence of governments in the new scheme as a hydra-headed monster. A hydra concurrently occupies a unitary and multiple identities, which is a helpful analogy for a collection of federal and state governments with individual interests who also hold standing as a single Ministerial Council.

This new national scheme is consistent with a model of ‘quasi-independence’. The paper also canvasses critiques of the scheme, and concludes with a consideration of the relative influence of governments before after this most significant national reform in health professional governance.