COAG under fire on medicos’ mandatory reporting bill

Queensland MPs are being called on to fix mandatory reporting legislation which the AMA says COAG got wrong.

Queensland Health Minister Steven Miles introduced the health practitioners bill. Picture: AAP

A parliamentary inquiry will deter­mine the fate of the medical profession’s mandatory reporting laws, which some blame for deterring doctors from seeking treatment themselves.

After 18 months of debate in the sector, and deliberations by official­s, the Council of Australian Governments Health Council approve­d a reform bill introduced into the Queensland parliament in October.

As Queensland is the host jurisdicti­on for the Health Practitioner Regulation National Law, any reforms must start there, althoug­h Western Australia is sticking with its alternative model of mandatory reporting.

The bill, introduced by Queensland Health Minister Steve­n Miles, was promptly referre­d to a parliamentary committee for an inquiry. It will report by February 4 next year, with amendments able to be made in parliament before a final vote.

At a recent hearing, the Departme­nt of Health’s Kathleen Forrester told committee members the bill was partly designed to “strike a better balance between improving access to treatment for practitioners with health conditions that potentially impact on their own practice while ensuring appropriate protections for consume­rs of health services”.

“These changes have come about in response to increased concerns from stakeholders that mandatory reporting requirements may be a factor in discouraging patient practitioners who are unwell from seeking treatment for their health issues, especia­lly mental health issues or drug and alcohol problems, for fear of being reported by their treating practitioner,” Forrester said.

“These concerns are serious because seeking treatment and support for health conditions is critically important to ensuring the health and wellbeing of prac­titioners, as well as the patients they care for.”

The current requirements have been cited as a possible contributi­ng factor to the suicide rate in the health profession, which is the highest among white-collar workers in Australia. Data released to The Weekend Aust­ralian from the National Coronial Information System shows that between January 1, 2011, and Decemb­er 31, 2014, there were 153 suicides in the profession.

A 2013 study by Beyondblue, involving more than 12,000 doctor­s, found the need to protect their medical registration was one of the perceived barriers to seeking mental health treatment.

Key health groups believe the reforms agreed to by the COAG Health Council do not go far enough, and have called on Queensland MPs to amend the bill before it is passed.

The president of the Australian Medical Associa­tion, Tony Barton­e, said the Queensland bill should more closely reflect the protections given to doctors under WA law.

“We need the law to provide confidence and peace of mind to doctors and medical students that they can seek mental health care without fear of reprisal or threat to their medical careers,” Bartone said.

“We do not want to see any more doctors or students taking their own lives because they were afraid to seek care.”

Bartone questioned the lack of changes to the bill before it was introduced, following consult­ation with a number of groups he said held similar concerns.

“The onus is now on the Queensland parliament to prevail where COAG has dithered,” he said.

Australian Medical Students Association president Alex Farrell echoed the AMA’s concerns, saying treating doctors should be exempte­d from the mandatory reportin­g requirements, as occurr­ed in WA.

“Doctors can seek the care they need, like everybody else,” Farrell said.

“We know from WA that this model keeps doctors safe without compromising patient safety.”

In the hearing, Forrester suggeste­d there had been “strong and sometimes quite divergent views” from stakeholders, and acknowled­ged that a large group had wanted a voluntary reporting requirement. She also revealed that, among health ministers on the COAG Health Council, only WA supported the WA model.

Forrester said the Queensland bill allowed treating practitioners, with official guidance, to assess whether the public was at substantial risk of harm from the patient’s illness.

“The use of the term ‘substantial’ suggests that it is not a minor or trivial risk, that there is something that is quite significant there that is a substantial risk,” she said.

Forrester said mandatory reportin­g was not an “automatic response to someone going in and saying they have a mental illness”.

“The treating practitioner needs to make that assessment considering all of the factors, including that: ‘the person may have a mental illness, they are here getting treatment, and I understand that mental illness. I understand that the treatment is an effective treatment. I understand my ­patient. I understand that they are highly likely to comply with the treatment and the patient is talking to me about the things that they are going to do in their life as well to support themselves to get better. Taking all of those factors into account I can assess, using the guidance factors, that the practition­er (patient) might have a mental illness, but their practice is not going to place the public at substantial risk of harm.’ ”