Legislative Council - Thursday 20 September 2018
Ms FORREST (Murchison) - Mr President, this is an important step forward in many respects because a number of healthcare providers are not subject to this review process. A few years ago when we debated the national health practitioner regulation process and adopted the national law, a number of professions, such as medical practitioners, nurses and physiotherapists, were initially put into that lot. Another cohort was then added to that regime.
I assume the addition of professions or healthcare workers under that regime is now complete and there are to be no more, and this is why we are moving down this path with the application of a code of conduct to these other healthcare workers not captured under the national scheme. I am seeking clarification that there are not to be any more healthcare workers added, otherwise you could be doubling up.
It is highly appropriate because we have seen some practitioners not operating in a safe way over time - particularly with bloodborne diseases that could be an issue, and also the general hygiene practices of some providers; for instance, some massage therapists and people like that are not captured under the national scheme. For those who may have therapeutic massages at various places, some places are very clean and have great practices but some may be a bit questionable, particularly when you see some practices in other parts of the world. Those instances are very important.
My other question relates to the period of two years from the date the service was provided: does this cover circumstances of a massage therapist, for example, sexually abusing a client? I read an account of a woman - not in Tasmania but in another part of Australia - who was having a massage from a male masseur and she was sexually assaulted but did not report it until some years later because she was so shocked it had happened. It is a bit like these instances of sexual abuse against children that we hear of and circumstances like that where it can take a while for a person to think, 'No, that was not okay and I want to make a complaint.'
I note it says that the commissioner has limited discretion to accept complaints outside this time frame, so in circumstances like that, I assume that would be a case that may be considered. Would that capture that sort of sexual misconduct or sexual abuse of a client, and would these circumstances be ones where lenience may be given to the time frame limitations for making a complaint about it?
The purpose of the bill is also to appoint the Health Complaints Commissioner to oversee this important process of scrutiny and regulation of the healthcare providers, and also to provide a monitoring function in relation to prohibition orders where prohibition orders have been issued. Is the commission adequately resourced for this? I hear from constituents who have made complaints to the Health Complaints Commissioner under the current arrangements - these complaints are usually related to access to hospitals or treatment they received in hospitals - that the time frames are extraordinary at times. They were told the reason is a lack staff to investigate the case or arrange the conciliation meetings, or whatever is determined to be the best way forward.
This will only work if there is resourcing. We are giving a significant extra workload to the Health Complaints Commissioner. They are not only dealing with complaints but also monitoring prohibition orders. Hopefully there will not be too many prohibition orders to monitor. I would like the Leader to indicate the resourcing that will be provided to the Health Complaints Commissioner to facilitate this, otherwise people making complaints will be waiting months to have their cases dealt with.
Another of my questions relates to mutual recognition of prohibition orders in other jurisdictions. If I understand correctly, if you have a prohibition order in another jurisdiction, you would breach it by operating in Tasmania. If the Health Complaints Commissioner issues a prohibition order, are they named and published on a website? I cannot see in the bill where it says specifically. The second reading speech says -
This will include publication of prohibition orders and public warning statements on a shared national website as required.
That is important for people looking for a practitioner, particularly in an area they do not know. When the commissioner issues a prohibition order or makes a public warning statement, there is a process of appeal through the Administrative Appeals Division of the Magistrates Court. When does that notification go up? Is it after that appeal period is finished? It could destroy someone's career or business if it is published immediately and is then overturned by the court.
Mr Valentine - It is too late then.
Ms FORREST - Yes, potentially the damage is done. I am trying to understand the process. It is important to do it, but the appeal period may be a period where perhaps they are not published. I am trying to understand the plan. The public should be made aware of those who have prohibition orders or public warning statements issued about their practice, but only when it is proven.
Mr Gaffney - It is a catch-22. If they do not suspend them or put them on notice and then they do something wrong and they repeat offend, what do you do there?
Ms FORREST - Yes, you need to protect the public, but you also need to ensure a person is not unfairly targeted.
Mr Valentine - Until you know what you are protecting them from, it is a bit difficult.
Ms FORREST Yes. I support the bill in principle. It is important to regulate these healthcare workers and to have a complaints process so that poor practices, misconduct and other behaviours can be dealt with. It is also important that the workers are protected as well. There are a few questions for the Leader.