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The Australian are reporting: Professions reject Govt control bid
Quote:
NURSES, midwives, physiotherapists and podiatrists have warned Australia's health ministers to keep their hands off their professions' training standards -- with doctors threatening to walk out of a new national registration and accreditation scheme.
Australian Medical Association president Rosanna Capolingua says dissent is spreading through the nine professions signed up to the Council of Australian Governments initiative, and doctors could be the first to abandon the proposal if their concerns were not addressed.
"We will assist, we will have dialogue, we will engage, we will try to make the model better, but we reserve the right to say 'no', if it doesn't come up to standards," she said.
In March, COAG announced the health professions -- doctors, nurses and midwives, physiotherapists, optometrists, chiropractors, pharmacists, dentists, psychologists and osteopaths -- would come under the new national scheme from July 2010.
The scheme aims to cut red tape for those moving interstate, and to protect the public by ensuring professionals' work histories follow them across state borders.
At the time only the AMA went public with its reservations, with nurses and others coming out in support of the announcement. But specialty groups representing obstetricians, gynaecologists, ophthalmologists, surgeons, urologists and anaesthetists have now signed off on the AMA's concerns.
Submissions to Health Workforce Australia, the agency charged with putting the new scheme in place, also reveal the extent of misgivings among other health workers about the power that will be held by health ministers.
The Australian Peak Nursing and Midwifery Forum says it "would not accept a situation where professional standards, accreditation of courses or related professional issues are decided by an organisation that is not based in the professions".
"These are critical issues that the APNMF believe require further in-depth discussion," its submission says.
The Australasian Podiatry Council says the profession must hold final responsibility for accreditation "rather than the Ministerial Council, as suggested in the intergovernmental agreement".
"The role of the Ministerial Council in providing final approval for registration and accreditation standards is in direct contradiction to the guidance given in the World Health Organisation/World Federation for Medical Education guidelines," it says. Those require accreditation of health workers to be independent of government.
The Australian Physiotherapy Council also warns attempts to impose government workforce policy on the professions could lower standards of education and practice.
COAG promises in its intergovernmental agreement that it would "not have any power to intervene in registration, examination or disciplinary decisions, or decisions relating to the accreditation of specific courses". But it nonetheless will approve accreditation standards and can ask for their review.
Federal Health Minister Nicola Roxon, who went head-to-head with the AMA to push through the proposal in March, was not immediately available for comment.
The scheme, which had been on COAG's books in various forms for years, was strongly backed by the new Government after a series of scandals over negligent and allegedly criminal behaviour by doctors shook public trust in the medical vetting and complaints handling procedures.
Opponents of the current registration and accreditation plan, however, are running out of time to press their case for revisions.
A first round of legislation to pave the way for the new scheme is to go before Queensland Parliament next month, as a model for the passage of similar bills in other states and territories.
The second round of legislation starting in August next year is likely to prove even more divisive, because it will flesh out the detail of lines of responsibility, methods of appointment, division of assets, and structures for fee-setting.
It will be a wrenching process for many of the boards, particularly for nursing and medical ones that were set up over a century ago supported by their own Acts of Parliament, and have the interests of staff, millions of dollars worth of assets, as well as their own state-specific memberships to protect.
But Capolingua says at the heart of the debate is the issue of professional standards.
She points to the conflict of interest inherent in state health ministers having a final say over health professional's educational requirements when they also pay their salaries. Those ministers could have a vested interest, for example, in shortening courses or redirect training to address short-term workforce shortages, she said.
"As employers, they are just interested in plugging a space so they don't come under pressure for not supplying services," Capolingua said. "We've been saying this from the very beginning (but) it's now been seen and understood by many of the other professional groups. The risk is the manipulation of standards by ministers, which would mean a lowering of standards of patient care."
The Australasian Podiatry Council says the profession must hold final responsibility for accreditation "rather than the Ministerial Council, as suggested in the intergovernmental agreement".
Currently the registration boards in most states hold this power for all professions, with some "sub contracting" this to other bodies.
For podiatry there is no nationally accepted course accreditation process, though a new body (the ANZPAC) involving the current reg boards as well as academic, community and professional association reps has been formed, that will most likely be the accrediting body.
__________________ Stephen Tucker Eastern Health
Podiatry Manager
Professions reject Govt control bid
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