Our Health Program
The Council's Health Program is relatively small, representing less than 5 per cent of referrals to the Council. However it is an important aspect of our work and in keeping with our main priority, which is to ensure the protection of the public while ensuring doctors are fit to practise and able to deliver care safely.
Medical practitioners are not immune to physical illness which may impact on their fitness to practise. They may also have mental health issues such as severe depression or addiction to alcohol or other drugs. Apart from the general risk factors they share with the rest of the community, doctors are also exposed to particular risks as a result of the stresses and responsibilities of professional life; access to prescription drugs and the temptation to treat themselves.
The Health Program is designed to support doctors whose health is impaired through supervision and guidance, with the ultimate goal they return to full health
This example below (Dr X) illustrates how we manage notifications about impaired doctors and medical students and how we work with them while protecting the public.
What is an impaired medical practitioner or student?
'Impairment' is a term defined in the National Law.
A medical practitioner is considered to have an impairment if he or she has a condition that may detrimentally affect the capacity to practise medicine.
A medical student whose capacity to undertake clinical training is detrimentally affected by his or her health may also be considered impaired.
An impaired medical practitioner or medical student is usually the concern of the Council’s Health Program.
The Council's approach to an impaired practitioner will depend on the nature of the illness, the degree of insight displayed, any existing treatment program, and most importantly, any perceived risk to patients and others if the doctor continues to practise.
Similar considerations apply to students who may have contact with the public in the course of their clinical training.
How does our Health Program work?
When a credible complaint or notification is received regarding a doctor who may be impaired, the Council may decide that the practitioner should be assessed by an independent medical practitioner appointed by the Council to assess the existence, extent, and nature of any impairment.
The Council appointed practitioner will not treat the practitioner but will provide a report to the Council which will decide in its Committee whether the doctor should attend an Impaired Registrants Panel Inquiry.
The Impaired Registrants Panel and Conditions
The Panel usually consists of two experienced medical practitioners who have the report of the Council appointed practitioner and will spend some time discussing the situation with the practitioner. The Panel may decide that in the circumstances nothing further is required. Alternatively, they may ask the doctor to agree to conditions on his or her registration.
Conditions may be practice conditions (such as a requirement to limit the hours of work) which will be noted on the doctor’s registration on the online register of practitioners.
A doctor may also have health conditions, for example a requirement to obtain treatment or to undertake drug or alcohol screening. Health conditions are private and will not be shown on the register.
If the practitioner agrees to comply with these conditions, s/he can continue to practise.
The Health Committee has the final say. It will consider the Panel's recommendations and any agreement reached with the practitioner and will normally endorse the proposed recommendations and conditions.
- In some instances, if an impaired practitioner lacks insight and the need for some limitation on his or her practice, it may be necessary for the practitioner to attend a hearing convened under s150 of the National Law. At this hearing, the Council will decide if it is necessary to take immediate action to protect the public, through the imposition of conditions or even suspension of the practitioner.
Health conditions and privacy
The law requires the Council to notify AHPRA of any conditions placed on a practitioner’s registration. Practice conditions are available to the public on the AHPRA website. Health conditions are referred to, but not published. The law also requires the Council to notify employers of all conditions imposed on a practitioner’s registration. However, they are not made available to any other third party, including the person who made the notification, unless the notifier is the practitioner’s employer.
The AHPRA website does not publish any information about students. Release of conditions to education providers must be with the student’s consent.
Guiding practitioners to recovery through monitoring
The Council’s Monitoring Team proactively monitors practitioners who are in the Health Program to ensure they are complying with their conditions. This may include drug testing, regular reviews or assessments. The practitioner is expected to comply fully with any conditions so as to assure the Council that they pose no risk to the public.
As the practitioner demonstrates evidence of progress in rehabilitation and recovery, the conditions on registration are gradually relaxed and/or removed. While a return to unconditional medical registration is a Health Program goal, a small number or practitioners, such as those with a recurring psychiatric illness, they may remain on the program indefinitely. They will be regularly reviewed by the Council Appointed Practitioner, the Impaired Registrants Panel and the Council.
What happens when a doctor breaches a Health Program condition?
If a doctor on the program who is wilfully and continually in breach of conditions, the Council may convene urgent section 150 proceedings which can result in a tightening of conditions or temporary suspension.
The Council may also refer the doctor to the Health Care Complaints Commission for investigation, which can lead to a prosecution in the NSW Civil and Administrative Tribunal. The Tribunal has the power to cancel a doctor’s medical registration.
Dr X - a Health Program case study
Dr X is a 60-year-old male GP who came to the attention of the Medical Council as a result of an investigation report by Pharmaceutical Services. The report indicated Dr X had written numerous prescriptions for pethidine in various patients’ names and that these prescriptions were for his own use.
In response, the Council initiated an urgent action to consider the need for immediate action under Section 150 of the National Health Regulation Law (NSW). As a result, the Council imposed a number of conditions on Dr X’s registration including that he be prohibited from prescribing, possessing and supplying any drug of addiction.
Dr X was also referred to an Impaired Registrants Panel which amended his conditions by requiring him to submit to urine drug screening and to attend for regular treatment of his drug dependency.
Thereafter Dr X joined the Health Program. Dr X engaged well with the program and remained compliant with his conditions over several years. Dr X reported that his involvement with the program allowed him to make major changes to his life and overcome his drug dependency.
Dr X reported that the support he received on the program was very helpful and the formal structure allowed him to keep working as a GP and doing what he loves. Dr X successfully exited the Council’s Health Program approximately three years after the initial notification.