Wednesday 22 February 2017

No longer in the shadowlands: regulation of unregistered health service providers

As of 1 February 2017, Victoria has a new health complaints system with the commencement of the Health Complaints Act 2016 (Act) and the appointment of the inaugural Victorian Health Complaints Commissioner, Karen Cusack. This new role replaces the former Health Services Commissioner.

It has been almost 30 years since the Victorian health complaints scheme was designed. In this time, the number and diversity of health services available have increased significantly.

Media reports over a number of years have highlighted the stories of vulnerable and unwell people, who have obtained health services from unregistered health service providers based on what they later realised were false or misleading claims about the efficacy of the treatment. In a number of cases, the treatment received has been experimental, costly, and provided to the potential detriment of the patient’s health in cases where other treatment options have been ignored or discouraged.

Previously, there was only limited recourse under consumer protection and trade practices legislation in situations where a person complained about an unregistered health service provider.

The new Act seeks to address the previous ‘shadowlands’ of unregistered health providers to better protect members of the public from receiving unsafe or non-efficacious health services.

Many providers of, what are often described as, 'alternative' or 'non-mainstream' health services are not subject to professional registration and, therefore, lie beyond the regulation of the 14 health profession boards and the Australian Health Practitioner Regulation Agency (AHPRA). The Health Practitioner Regulation National Law (Victoria) Act 2009 is also not directed at preventing a registered health practitioner from providing unsafe, non-efficacious or unethical health services where such treatment is outside the scope of their professional registration.

The Act applies to all providers of a 'health service'. This term is defined broadly in the Act and focuses on the purpose of the activity. For example, any activity intended or claimed to 'assess, predict, maintain or improve [a] person's physical, mental or psychological health or status', as well as therapeutic counselling services. Importantly, the Act introduces a Code of Conduct that sets standards for the provision of safe and ethical health services.

The Act seeks to promote the efficient and effective management of complaints with a focus on conciliation. However, where a complaint cannot be resolved, the Act provides the Commissioner with significant powers to investigate complaints and take action against unsafe or unethical health service providers.

Powers of the Health Complaints Commissioner

The Health Complaints Commissioner has power under the Act to:
  • investigate complaints about the provision of 'health services', including by:
    • unregistered practitioners
    • registered practitioners providing health services outside the scope of their professional registration
    • formerly registered practitioners
  • conduct own motion investigations where no specific complaint has been received
  • accept complaints from affected individuals and third parties, including carers, health practitioners or other healthcare providers
  • make prohibition orders to prevent unsafe or unethical services or products 
  • enter and search premises, order the production of documents, and call persons to give evidence at an investigation hearing before the Commissioner 
  • set penalties for failing to comply with investigation hearing notices and interim prohibition orders of the Commissioner (including up to two years' imprisonment)
  • ban unregulated healthcare providers from providing health services in Victoria where they are prohibited from practising in other states
  • publish public health warnings and publicly name providers
The new Health Complaints Act is a welcome step to fill the regulatory gap that existed between unregistered healthcare providers and registered health practitioners to ensure better protection for the health and wellbeing of the public.

Health Complaints Commissioner
Code of conduct

Joanne Kummrow
Special Counsel
03 8684 0462

Andrew Field
Managing Principal Solicitor
03 8684 0889

Michele Rowland
Principal Solicitor
03 8684 0413

This blog was prepared with the assistance of Mary Quinn, Solicitor, and Milli Allan, Trainee Lawyer.

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