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ROLES AND RESPONSIBILITIES

OF PROFESSIONAL

REGULATORS

KATIE ELKIN

International Medical Graduates in

Australia

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Medicine: A regulated profession

Protection

of thepublic

Protection

of theprofession

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Balancing the interests

The stateThe publicThe profession

Interests may coexist but public protection(or public interest?) must be

paramount

Registration and training requirements must be set at the levelrequired to ensure public safety, and not at a higher level thatprovides more economic benefits to the health professions than iswarranted

NZ Ministry of Health, 2012

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Public protection

Public interest

Public protection vs public interest (cont.)

Four interrelated and essential elements of the rightto health : UNESCO

Quality

Acceptability

Availability

Accessibility

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It appears that in times of perceived workforceshortage, considerations of workforce supply

may take precedence over issues of standardswith potentially adverse outcomes for patientsafety.

AMC submission, 2011:

Lost in the Labyrinth, 2012

Public protection vs public interest (cont.)

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Responsibilities of Medical Boards and Councils

Regulatory functions as per relevant legislation

Mandate comes from that legislation

Functions to be exercised in accordance with thatlegislation

Australia: pre-2010

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Responsibilities of the Medical Boards and Councils

Australia: National Laws Act

Objectives (Pt 1, s 3) include:

to provide for the protection of the publicby ensuringthat only health practitioners who are suitably trainedand qualified to practise in a competent and ethicalmanner are registered

to facilitate access to services provided by healthpractitioners in accordance with the public interest

to facilitate the rigorous and responsive assessment ofoverseas-trained health practitioners

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Responsibilities of the Medical Boards and Councils

Australia: National Laws Act (cont.)

Guiding principles (Pt 1, s 3) include that:

restrictions on the practice of a health profession are tobe imposed under the scheme only if it is necessary toensure health services are provided safely and are of anappropriate quality.

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Responsibilities of Medical Boards and Councils

New Zealand: since 2004

Health Practitioners Competence Assurance Act

2003 In practice too, a more conservative approach to

IMG registration than in Australia

Despite even greater reliance on IMGs (43% cf37%)

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Balancing protection and supply

Have we got the balance

right?

How do we measure it?Research

High profile scandals

Comments by regulators

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Balancing protection and supply

Lost in the Labyrinth, 2012

Submissions

Recommendations

objective guidelines

workplace assessments

time in hospitals

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Final word

it is my sincere hope that the reportsrecommendations will help ensure that

those wishing to practice medicine andcall Australia home in future may do sowith certainty and clarity of what isexpected of them

Forward to Lost in the Labyrinth, 2012