Horrendous cost of persecuting doctors

Kara Thomas - Secretary of the Australian Medical Professionals Society Posted with the kind permission of the Author. The article first appeared in Quadrant. See below for open access.

Quadrant is now open access: https://quadrant.org.au/news-opinions/health/horrendous-cost-of-persecuting-doctors/

Horrendous cost of persecuting doctors

Kara Thomas - Secretary of the Australian Medical Professionals Society

Posted with the kind permission of the Author. The article first appeared in Quadrant.

The Medical regulator needs urgent reform

The dramatic erosion of trust in Australia's medical institutions represents more than just statistics - it reflects a profound crisis in healthcare that demands immediate action. The recent government COVID-19 Response Inquiry Report reveals an alarming collapse in public confidence, with trust in science, in government and in medicine plummeting as a result of the government's non-transparent heavy-handed response to COVID-19. In the US, trust in the medical profession fell from 71.5 per cent in 2020 to just 40.1 per cent by 2024. Behind these numbers lies a complex web of systemic failures. In Australia, the heavy-handed regulatory approach of the Australian Health Practitioner Regulation Agency (AHPRA) is a core contributing element.

The federal COVID-19 inquiry confirmed what many practitioners have long known: vaccine mandates and the suppression of informed consent and clinical autonomy have devastated public trust. But AHPRA's problems run far deeper. The Australian Medical Professionals Society’s recent survey of medical practitioners paints a disturbing picture of an organisation that has lost its way. When 82.6 per cent of healthcare professionals believe AHPRA lacks fairness and transparency in handling complaints, and 78.5 per cent report unfair treatment, we face a crisis that threatens the very foundation of medical practice in Australia.

Most alarming is AHPRA's ‘guilty until proven innocent’ approach to investigations. With one in five medical practitioners having faced notifications, the human toll is staggering. Practitioners report years-long investigations, career-destroying delays, and devastating financial and mental health impacts. Many contemplate leaving the profession entirely. The acceptance of anonymous complaints and the punitive nature of investigations without proper vetting has created a culture of fear, where doctors have said they now practise risk averse defensive medicine.

The COVID-19 pandemic exposed and exacerbated these systemic flaws. The recent Bay v Australian Health Practitioner Regulation Agency [2024] QSC 315 (13 December 2024) Court judgement specifically noted that while the pandemic was "an extraordinary period of history," it did not authorise AHPRA to "abrogate the right of persons to a hearing before an apparently unbiased tribunal" or extend AHPRA's role to "include protection of government and regulatory agencies from political criticism."

Yet practitioners who have questioned official narratives in policy areas such as gender affirmation guidelines, abortion and euthanasia, as well as the government response to Covid – instead seeking to provide individualised patient care – faced investigation and disciplinary actions that can take many years to finalise and can result in cancellation of their registration or the imposition of severely restrictive conditions.

Practitioners that requested risk assessments on the vaccines were terminated for non-compliance with government policy which was considered by regulators and government to constitute serious professional misconduct.

The erosion of informed consent principles and clinical autonomy has left both doctors and patients questioning whether healthcare decisions truly serve individual needs or merely satisfy bureaucratic demands, leading to a catastrophic deterioration in trust.

The consequences are far-reaching. Practitioners increasingly avoid complex cases, fearing regulatory reprisal. The mental health toll on medical professionals is severe, with many reporting anxiety, depression, and suicidal ideation during investigations. This climate of fear and mistrust ultimately harms patients, who deserve healthcare providers focused on their wellbeing rather than regulatory compliance.

The time for incremental change has passed. We are calling for five essential reforms:

1. A complete structural overhaul of AHPRA.

The system, which has lost the confidence of both practitioners and the public, must be reformed to restore balance between regulatory oversight and clinical autonomy. Power and accountability must be devolved to individual States and Territories with elected not appointed boards. This includes redefining AHPRA's scope to focus on core regulatory functions rather than enforcing unscientific politically-conceived public health guidelines.

2. Strict timelines for investigations must be legislated.

Section 162 of the Health Practitioner Regulation National Law Act 2009 states; “Investigation to be conducted in timely way. The National Board must ensure an investigator it directs to conduct an investigation conducts the investigation as quickly as practicable, having regard to the nature of the matter to be investigated.” In practice, investigations are open-ended and have no defined legislative time frame and can drag on for years, destroying careers and lives. A maximum six-month timeline for standard investigations, with extensions only in exceptional circumstances and with judicial oversight, would protect both practitioners and the public interest.

3. Anonymous complaints and any investigation must be restricted to cases where there is a serious, demonstrable risk to complainant safety.

The system enables vexatious complaints that waste resources and devastate practitioners' lives. Complainants should be required to identify themselves unless they can prove legitimate fear of reprisal. All complaints must undergo rigorous assessment to demonstrate how they meet the threshold for serious risk to clinical patient care. The national law must not be misused as a political weapon to silence health practitioners from exercising their rights to intellectual freedom and political communication.

4. The principle of innocence until proven guilty must be restored.

AHPRA's approach of presumed guilt has no place in a just regulatory system. Practitioners should maintain their right to practise unless there is clear evidence of danger to public safety.

5. Establishment of an independent oversight body with real power to review AHPRA's decisions.

This body should include experienced medical practitioners and legal experts, ensuring decisions reflect both clinical realities and principles of natural justice. It should provide an appeal process with the potential for meaningful outcomes for practitioners.

These reforms are essential to restoring trust and protecting both practitioners and patients. The survey data is clear: the system is broken. When medical practitioners give AHPRA an average satisfaction rating of just 1.7 out of 10, with over half giving the lowest possible score, we cannot ignore the crisis any longer.

The health of our nation depends on fixing this broken system. The reforms are clear. The need is urgent. To restore trust, the time for change is now.

Kara Thomas - Secretary of the Australian Medical Professionals Society