Completed regulatory reform projects

There are laws in Victoria that regulate Chinese medicine practitioners. The Chinese Medicine Registration Act 2000 was developed following an extensive consultation process. Victoria was the first Australian state to register Chinese medicine practitioners.

The process commenced in 1995 as part of a review of traditional Chinese medicine by the previous Victorian Department of Health and Community Services.

Regulation of Chinese medicine practitioners

The Act provided for the registration of:

• Chinese herbal medicine practitioners
• acupuncturists
• Chinese herbal dispensers.

The Chinese Medicine Registration Acthas since been repealed by the Health Professions Registration Act 2005, which came into effect on 1 July 2007. However, the key reforms for regulation of Chinese medicine practitioners are retained in more recent laws.

Consultation, review and publication

A range of archive material exists on Chinese medicine practitioner registration in Victoria, covering the earlier review of traditional Chinese medicine and the subsequent consultation, review and implementation of the legislation:

• Newsletter No. 1 February 1996 (English and Chinese versions)
• Newsletter No. 2 November 1996
• Newsletters No. 3, 4 & 5 summary
• Newsletter No. 6 July 2000 (English and Chinese versions)
• Newsletter No. 7 February 2001 (English and Chinese versions)
• Traditional Chinese medicine – report on options for regulation of practitioners July 1998
• Review of traditional Chinese medicine discussion paper – options for regulation of the profession of traditional Chinese medicine, September 1997
• Towards a safer choice – the practice of traditional Chinese medicine in Australia, November 1996.

To access archival material, please contact workfoce.regulatory.reform@dhhs.vic.gov.au or phone (03) 9096 7651.

Background

In 2003 the department released Regulation of the health profession in Victoria: a discussion paper. This gave practitioners, professional associations and interested consumers the opportunity to comment on proposals for the reform of the Victorian health professions regulatory system.

Seventeen submissions were received in response to this review addressing the issue of ‘recovered memory therapy’. This therapy also known as ‘repressed memory therapy’ or ‘false memory therapy’.

The majority of the submissions claimed that ‘recovered memory therapy’ in use by some mental health therapists in Victoria was resulting in false accusations of child sexual abuse.

Given the complexity of the related issues, a more detailed examination was required to determine the need, if any, for legislative and/or other reforms.

Inquiry into the Practice of Recovered Memory Therapy

In November 2004 the Minister for Health requested that the Health Services Commissioner conduct an inquiry into the practice of ‘recovered memory therapy’ under s. 9(1)(m) of the Health Services (Conciliation and Review) Act 1987.

The commissioner’s final report is below.

Recommendations

Based on the findings of the inquiry, the Health Services Commissioner had the following recommendations.

Review of training

Collaboration between universities, professional bodies and accredited teaching organisations to review the adequacy of training regarding trauma, with a view to ensuring practitioners are being adequately trained.

Best practice guidelines

Establishment of best practice guidelines related to recovered memories by professional bodies, including those for registered and unregistered practitioners, and registration boards (where not already established).

Membership of professional organisations

All unregistered providers of trauma counselling, psychotherapy and hypnotherapy services become members of a suitable professional organisation within their profession.

Community education

The Department of Human Services takes a leadership role with professional bodies, registration boards and advocacy groups to conduct a community education campaign. The aim of this campaign is to provide members of the public with the information they need to choose appropriately qualified practitioners.

Continuous monitoring

The Office of the Health Services Commissioner continue to monitor concerns expressed by all interested parties about ‘recovered memory therapy’.

Government response

In response to the commissioner’s recommendations, the Minister will be requesting advice from the relevant registration boards and professional bodies on the report’s recommendations and potential roles they might play in progressing implementation of these.

Advice was sought on issues such as:

• community education to help people choose an appropriately qualified mental health practitioner
• preparation and/or review of practice guidelines related to recovered memories.

Review of training in trauma counselling

Mechanisms will also be put into place to maintain a watching brief on the issues identified in the report.

Downloads

In 2003–04 the Department of Human Services commissioned research on models of self-regulation for psychotherapy and counselling practitioners and other unregistered health professions.

The Psychotherapy and Counselling Federation of Australia (PACFA) conducted the study on behalf of the Department.

The study included:

• a review of models of best practice in self-regulation
• focused consultation with PACFA member associations
• broader consultation with peak bodies that represent other unregistered health professions and experts in the field.

Aims of the study

The study had the following three key aims.

Best practice models

Develop a best practice model for self-regulation of counselling and psychotherapy practitioners in Australia based on:

• a critical review of the literature
• consultation with experts and key stakeholders
• political/economic considerations.

Feasibility of self-regulation

Explore the feasibility of establishing joint self-regulatory arrangements with other self-regulated health practitioners.

Stakeholder consultation and agreement

Work collaboratively with stakeholders to reach agreement on a plan for implementing key features of an effective and efficient self-regulatory model that is:

• publicly accountable
• provides adequate protection for consumers.

Final research report

Best practice self-regulation model for psychotherapy and counselling in Australia: final report was submitted to the department in February 2008.

The final report included a detailed description of consultation and outcomes from the research including:

• a literature review on international models for regulation of counselling and psychotherapy
• mapping of the history, structures and self-regulatory arrangements for close to 50 counselling and psychotherapy associations in Australia
• workforce surveying of counselling and psychotherapy practitioners
• consultation with representative associations on a proposal for a joint self-regulation model with other unregulated health professions
• a project to develop a national course accreditation system for these practitioners
• national consultation on best practice models for regulation of counselling and psychotherapy.

The views expressed in the report by the research team do not necessarily represent the views of the department.

Submissions to the review

The department invited submissions from interested parties on the report and its findings and recommendations. Submissions closed on 29 August 2008.

The following organisations or individuals made submissions to the review:

• Association of Transpersonal and Emotional Release Counsellors
• Australian and New Zealand Society of Jungian Analysts
• Australian Centre for Psychoanalysis
• Australian Counselling Association
• Australian Hypnotherapists’ Association
• Australian Psychoanalytical Society
• Australian Society of Rehabilitation Counsellors
• Centre for Child and Family Development
• Clinical Counsellors Association
• Colac Counselling Service
• Counsellors and Psychotherapists Association of Victoria
• Federation of Victorian Counsellors
• Gestalt Australia and New Zealand
• Ms Jillian Lynch
• New South Wales Institute of Family Psychology
• Psychotherapists and Counsellors Association of Western Australia
• Psychotherapy and Counselling Federation of Australia
• Queensland Counsellors Association
• School of Public Health, La Trobe University
• The Kairos Centre.

Self-regulation models

Following the release of the final research report, the PACFA and the Australian Counselling Association (ACA) collaborated to develop a single register: the Australian Register of Counsellors and Psychotherapists (ARCAP).

This register aims to be an inclusive national listing of credentialled counsellors and psychotherapists who accept the standards, codes of conduct and ethics, insurance and continuing education requirements of recognised clinical and professional member associations.

The Australian Register of Counsellors and Psychotherapists is an independent, national register of qualified counsellors and psychotherapists. All practitioners listed on the register have completed professional qualifications in counselling or psychotherapy, meet ongoing professional development requirements and have clinical supervision of their practice to ensure they provide a quality service to clients and abide by the ethical guidelines of the profession.

Background

Between 2002–03 and 2003–04, the department conducted a review of pharmacy legislation. Part of the review was to implement nationally agreed national competition policy (NCP) reforms to the provisions regulating ownership of pharmacies in Victoria.

On 16 November 2004 the Pharmacy Practice Act 2004 came into operation and introduced provisions that cap the growth of friendly society pharmacy ownership. These provisions were enacted for a four-year period, which began on 16 November 2004 (under the now repealed Pharmacy Practice Act) and were due to end on 16 November 2008 under the current Health Professions Registration Act 2005 (‘the Act’) that came into operation on 1 July 2007.

Regulation of pharmacy ownership

Under s. 101(1) of the Act, only the following are legally allowed to own or hold a proprietary interest in a pharmacy business:

• registered pharmacists
• pharmacist-owned companies
• legal entities known as ‘friendly societies’ that meet the statutory criteria set out in s. 101(1)(c).

Limits on pharmacy ownership

The Act provides limits as to the number of pharmacies that may be owned.

Section 101(2) of the Act limits to five the number of pharmacies a pharmacist or pharmacist-owned company may own.

Section 174(4) provides that:

• friendly societies that own fewer than six pharmacies are permitted to own a maximum of six
• friendly societies that own more than six pharmacies may grow by 30 per cent over four years.

These provisions that cap the growth of friendly society pharmacy ownership were due to end on 16 November 2008.

Terms of reference

The department’s Service and Workforce Planning Branch conducted the review of the effect of s. 174(4) of the Act.

The aim of the review was to identify and assess the costs and benefits of the growth cap on friendly society pharmacy ownership in Victoria, with a view to formulating advice on the legislation in relation to friendly society pharmacy ownership.

In making recommendations to the Minister for Health, the department took into account the following:

• the regulatory principles and framework set out in the Victorian guide to regulationpublished by the Victorian Competition and Efficiency Commission (VCEC)
• stakeholder views, including pharmacists, pharmacy professional associations and consumers and their representative groups
• Council of Australian Governments (COAG) decisions of July 2006 and April 2007 to establish a national registration and accreditation scheme for the nine health occupations regulated in all states and territories, including pharmacy.

Consultation and submissions on the review

Prior to the passage of the Pharmacy Practice Actin November 2004, there were no legislative restrictions on the number of pharmacies that could be owned by friendly societies in Victoria.

The provisions that cap friendly society pharmacy ownership represented a new restriction on the expansion of friendly society ownership of pharmacies in Victoria. The Minister for Health at the time gave a commitment to review the effects of this restriction before the provisions sunsetted on 16 November 2008.

The department invited submissions from interested parties and the following were received:

• Association of Professional Engineers, Scientists and Managers, Australia – Pharmacists Division
• Australian Friendly Societies Pharmacies Association
• National Pharmacies
• Pharmaceutical Society of Australia, Victorian Branch
• Pharmacy Board of Victoria
• The Pharmacy Guild of Australia
• Society of Hospital Pharmacists of Australia, Victorian Branch
• United Friendly Society Dispensaries
• Victorian Friendly Societies Pharmacies Association.

Outcomes and amendments

Amendments to the Act passed through the Victorian Parliament on 11 November 2008 and received royal assent on 14 November 2008.

As part of these amendments, the Victorian Parliament approved:

• extending the growth cap for pharmacy ownership by friendly society type companies indefinitely
• providing for controlled growth for pharmacy ownership by friendly societies that owned six or more pharmacy businesses before 17 November 2008.

These provisions are outlined under s. 174 of the Act.

Background

The previous Victorian model of health practitioner registration was introduced in 1993–94, with the passage of the Nurses Act 1993 and the Medical Practice Act 1994. Eight new Acts of Parliament were subsequently passed and common core provisions were introduced to regulate the registered health professions. However, not all of the health practitioner registration Acts were updated to incorporate the modern provisions.

In May 2002 the Victorian Parliament passed a series of significant reforms to the Medical Practice Act 1994. These included powers for the Medical Practitioners Board of Victoria to regulate:

• practitioners who may have been performing poorly
• corporate owners of medical practices.

The review provided the opportunity to consider whether legislation and reforms introduced since 1993–94 in various Acts should be extended to cover all of the registered health professions.

The review was also an opportunity to examine the Victorian model of health practitioner regulation to make sure that the legislative framework:

• equipped the registration boards to protect the public
• addressed emerging challenges in the regulation of the health professions.

Following a public announcement by the then Minister for Health, the Hon. John Thwaites MP, the department’s review of the regulation of the health professions began in late 2002.

Objectives of the review

The review’s three main objectives were to:

• ensure the framework for regulating Victoria’s health professionals was up to date, responsive and equipped health practitioner registration boards to protect the public and address emerging challenges
• promote consumer and community confidence in the operation of Victoria’s regulatory scheme
• ensure good links existed between the mechanisms that oversee practitioner quality and those that ensure health system quality.

Principles for reform

The review was guided by the following principles for reform.

Accountability

Registration boards should be accountable to the Victorian community for their decisions and operations.

Transparency

The decision-making processes of registration boards should be open, clear and understandable to both consumers and professionals.

Fairness

Registration boards should maintain an acceptable balance between protecting patients’/consumers’ rights and interests, and those of the regulated health professionals.

Effectiveness

The regulatory system should be effective in protecting the public from harm while supporting and fostering the provision of high-quality care.

Efficiency

The resources expended and the administrative burden imposed by the health professions regulatory system should be justified in terms of the benefits to the Victorian community.

Flexibility

The regulatory system should be able to respond to emerging issues in a timely manner as the healthcare system evolves and the roles and functions of health professionals change.

Consistency

There should be consistency across Australian states and territories in the regulatory arrangements for the health professions.

Discussion paper – October 2003

A 2003 discussion paper provided practitioners, professional associations and interested consumers the opportunity to comment on proposals for the reform of the Victorian health professions regulatory system.

Options paper – April 2005

Following consideration of the issues raised in submissions to the discussion paper, the department released a 2005 options paper with various proposals for structural and legislative reform.

Consultation – May 2005

To allow interested parties to comment on the issues raised in the discussion paper, the department held a further round of consultation early in May 2005.

Final reforms – July 2005

Following consultation, the proposed reforms were finalised and in-principle approval was granted to begin drafting new legislation.

Various minor reforms were introduced by the Health Legislation (Miscellaneous Amendments) Act 2005, which was passed by the Victorian Parliament on 19 July 2005. These minor reforms were identified through the review process as amendments that could be made immediately to improve the functionality and administration of various boards.

Health Professions Registration Act 2005

However, the key result of the review was the passage of the Health Professions Registration Act 2005, which came into operation on 1 July 2007.

Commissioned research

A range of research projects were commissioned as part of the Review of the Regulation of the Health Professions in Victoria,including:

Inquiry into the Practice of Recovered Memory Therapy

Seventeen submissions were received in response to the review’s discussion paper. In November 2004 the Minister for Health requested the Health Services Commissioner conduct an inquiry into the practice of ‘recovered memory therapy’ in Victoria under s. 9(1)(m) of the Health Services (Conciliation and Review) Act 1987.

For more information see:

Inquiry into the Practice of Recovered Memory Therapy

In 2002–03 the Department of Human Services funded a study of naturopathy and Western herbal medicine (WHM) practice.

Research team

The study was undertaken by a consortium of researchers:

• La Trobe University (lead agency)
• University of Western Sydney
• Australian Centre for Complementary Medicine Education and Research
• RMIT University
• Cochrane Group on Consumer Information and Communication
• National Herbalists Association Australia.

Aims and objectives

The study aimed to:

• investigate and understand the practice of naturopathy and WHM in Australia
• make recommendations on the need (if any) for measures to protect the public.

The objectives of the study were to:

• identify the scope and nature of practice of the professions of naturopathy and WHM, and the characteristics of the workforce in Australia

• understand the reasons patients choose naturopathy and WHM, and any concerns or issues they have

• understand the risks and benefits associated with the practice of naturopathy and WHM
• identify the extent to which members of registered health professions are adopting naturopathic and WHM modalities and their training in these modalities
• identify referral patterns and links between naturopathy/WHM practitioners and other healthcare providers
• profile the education and training available to persons entering and practising these professions, and assess its adequacy
• understand the aims and activities of professional associations representing practitioners of naturopathy and WHM
• identify the extent of institutional support for the practice of naturopathy and Western herbal medicine in Australia
• assess the impact of regulatory arrangements on the practice of naturopathy and WHM in Australia and overseas
• assess the features of naturopathy and WHM against the AHMAC criteria for assessing the need for statutory regulation of unregulated health occupations
• explore models of regulation and other measures to protect consumers of naturopathy and WHM.

Consultation, review and publication

The department invited submissions from interested parties on the report of the study and its findings and recommendations. Submissions closed on 31 October 2006.

The department then referred the report to the Australia Health Ministers Advisory Council (AHMAC) for consideration.

The final report of the study was released on 14 August 2006.