Home' Australian Ageing Agenda : AAA Jan-Feb 2014 Contents Australia's health ministers
have committed to
standards of conduct for
unregistered health workers
including aged care's 175,000 personal
care workers, having rejected a bid to
bring them under the national registration
and accreditation scheme (NRAS) as not
value for money.
At the Standing Council on Health
meeting in August, health ministers
reviewed several options for regulating
Australia's unregistered health workers
and ultimately decided against proceeding
with national registration.
The Australian Health Ministers'
Advisory Council (AHMAC) report
delivered to ministers after lengthy
consultation said a national code of
conduct was cheaper and would deliver
similar benefits as expanding the NRAS.
The report was critical of the perceived
added protections offered by statutory
registration and said the first-year costs to
regulate an additional 34 professions and
occupations alone would be in excess of
$94 million, compared with $1.6 million
under a code of conduct.
The AHMAC said that while statutory
registration reduces harm to the public,
it does not eliminate it. It noted that
while the national registration scheme
mandated additional entry to practice
requirements, regulatory action against
a registered practitioner was generally
triggered by a complaint, as would be the
case under a national code of conduct.
The decision brings to a close a
highly divisive debate about the merits
of registration, which drew strong
support from the Australian Nursing and
Midwifery Federation and Bupa Australia
but was rejected by the Caring for Older
Australians Productivity Commission
inquiry in 2011 and opposed by United
Voice and the former Royal College of
Under the proposed regulatory scheme,
which is already in force in New South
Wales and South Australia, a national
code of conduct would set out mandatory
professional standards of practice for all
unregistered health workers.
The states and territories would also
be given the powers to prohibit or limit a
person's practice in the event of a serious
breach of the code and a national register
of prohibition orders would also be made
publicly accessible online.
In NSW, the state Health Care
Complaints Commission has investigated
over 40 complaints against unregistered
health workers in 2009-2011 and issued
prohibition orders in 17 cases, since a
code of conduct was introduced.
The NSW HCCC says it receives
approximately 90 complaints each year.
However, the commission only conducts a
formal investigation of a complaint when
its preliminary assessment indicates there
is a serious risk to public health or safety.
Assistants in nursing have attracted two
complaints between 2008 and 2010.
As part of the regulatory scheme,
also known as 'negative licensing',
the commission has memorandums of
understanding with the NSW Police and
a number of other regulatory agencies
which allow for the sharing of information
In March 2013, a code of conduct for
unregistered health workers came into
effect in South Australia.
In addition to protecting the public, the
AHMAC noted that a mandatory code of
conduct would not raise the barriers to
Unlike national registration, a national
code would maintain the current open
marketplace for unregistered health
services and may even increase competition
between registered and unregistered health
workers by increasing consumer confidence
in unregistered health professions, the
AHMAC report said controversially.
"For example, a consumer who would
normally choose to see a psychologist may
choose to see an unregistered counsellor,
if he or she knows that the counsellor is
bound by a statutory Code of Conduct,"
the report said.
Overall, the option to set up a national
code of conduct was supported by
the majority of the respondents to the
consultation process and only 20 per
cent recommended extending statutory
registration to unregistered health
workers as their preferred option.
However, a statutory code was seen
by many professions as supporting
and reinforcing self-regulation through
professional associations. This may ignite
calls for a specific professional peak body
to represent the large carer or assistant
Australia's health ministers have
asked the AHMAC to undertake public
consultation on the terms of the
first national code of conduct and its
debate over the
licensing of personal
care workers has
been put to bed
with federal, state
and territory health
national registration to
this workforce, reports
www.australianageingagenda.com.au | 37
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