AHPRA accused of not investigating medical complaints properly
A woman has accused the national health regulator of failing to properly investigate her serious complaint against a doctor, as whistleblowers say understaffing, a toxic culture and pressure to meet unrealistic targets at the organisation are putting public safety at risk.
“The public’s not being adequately protected,” David Gardner, former investigator and team leader at the Australian Health Practitioners Regulation Agency (AHPRA), told 7.30.
“There are some practitioners out there who pose great risk and they’re not being properly monitored or investigated.”
His assessment was backed up by Toby Latcham, who worked as a data analyst and investigator for AHPRA for five years before taking stress leave.
“If you have a concern about a doctor, if you’ve been harmed or if there is a risk of harm, we won’t substantively respond to that harm for months,” he said.
“We’re too busy trying to put out fires.”
Complaint alleging ‘horrendous’ examination ignored
Pamela Robertson made a complaint to AHPRA in July 2018 about what she described as an “horrendous” internal examination by a doctor in Queensland.
“I’ve had vaginal surgery, I’ve had pap smears, nothing like this … I just remember thinking this was a violation of my body,” she told 7.30.
“I said you have to stop. And at that point I withdrew consent.”
But she said the doctor did not stop his examination.
“I had difficulty sitting for over a week, I had bleeding from the vagina,” she said.
Mrs Robertson complained to AHPRA alleging the doctor was aggressive, did not stop when she told him to, and silenced her when she asked questions.
She also made a complaint to police.
But Mrs Robertson was shocked when an AHPRA investigator told her they would not progress the investigation until police had completed their enquiries.
“It was a huge thing. And if they weren’t going to take that as a priority, I wasn’t sure how they’d prioritise their cases and their investigations,” she said.
Mrs Robertson heard nothing further from AHPRA, apart from a letter informing her that her case manager had been changed, until after 7.30 told the agency it had been speaking to her.
At the beginning of July AHPRA sent her a letter saying the police had completed their investigation, that it was still looking at her complaint, and that the doctor surrendered his medical licence in December last year.
After investigating Mrs Robinson’s complaint, police did not lay charges against the practitioner and closed the case.
AHPRA confirmed to 7.30 it had not actually asked the doctor to surrender his licence, and it had put no restrictions on his practice in the five months between Mrs Robertson making the complaint and him giving up his licence.
Mrs Robertson is angry.
“My case was serious, very serious, and it wasn’t investigated promptly,” she said.
“I wasn’t kept informed, and I don’t believe that they’ve held anybody to account over it.”
7.30 contacted the doctor, who said AHPRA was investigating, so declined to comment.
Workload means investigators ‘can’t do their job’
Mr Gardner does not know the specific details of Mrs Robertson’s case, but he believes AHPRA should not have waited for police to finish their investigation.
“There’s no real need for them not to have investigated and they should have investigated for public safety reasons,” he told 7.30.
He emphasised that in a case such as this AHPRA should have been investigating serious claims about a doctor’s clinical practice, which are different from any potential criminality, so it should not have waited.
AHPRA regulates more than 740,000 doctors, nurses and other health professionals and is the main body for investigating complaints about practitioners in most states.
“For the most part there was no time to sit down and go through a matter to obtain evidence. You were struggling to keep your head above water every day,” Mr Gardner, who left the agency in mid-2018, said.
“There are times when investigators would have 100 files.
“We aimed for investigators at the front end to have no more than 50 … so when they’ve got 100, they can’t do their job.”
Mr Gardner warned that as well as investigators having an unmanageable workload, the agency also had chronic technology and information storage problems.
He said when he was working as an investigator in Adelaide in 2016 he accidentally stumbled upon a computer folder that contained years of complaints made in NSW that had never been investigated.
Mr Gardner was moved to NSW to work on closing the 150 complaints, with the help of just one colleague.
“A lot of those files I had to do a quite cursory inspection, the best investigation I could, and then close them because they were too old,” he said.
AHPRA told 7.30 in a statement Mr Gardner’s information “was old”, and it had just this month changed the rules in NSW so it could now investigate complaints reported more than six months after an alleged offence.
7.30 has spoken to several other former AHPRA employees, who declined to go on the record, but who corroborated Mr Gardner and Mr Latcham’s depiction of investigators struggling under an unmanageable workload.
Mr Latcham said he raised concerns about a new triage model that was being trialled in Queensland, which initially resulted in a tripling of complaints without a corresponding increase in investigators.
He said his concerns fell on deaf ears and his frustrations ended up making him mentally unwell.
“If you ever want to feel that life is meaningless, spend some time at AHPRA,” he said.
“Because we have people’s lives in our hands, and in many ways we couldn’t care less.”
Medical practitioners also critical of investigation process
In a statement to 7.30, AHPRA said it was seeking to improve its work relating to investigation time, assessing risk to patients and improving communication.
“We have improved our operations and increased our staffing in the last 18 months. The usual caseload for our investigators is now between 25 and 30 matters,” the statement said.
It added that despite the number of notifications increasing by 20 per cent, it had reduced the time to manage a notification by 6.9 per cent.
“We now routinely and quickly assess all notifications … then prioritise our management based on risk to the public,” it said.
According to AHPRA’s 2017-18 annual report, almost 20 per cent of investigations took more than a year to close.
A survey of 3,500 notifiers which was conducted by the regulator in that financial year found 70 per cent were unhappy with the outcome of their complaint.
The same survey found 90 per cent of practitioners who had notifications made about them found the process “very stressful”.
Gary Fettke, an orthopaedic surgeon based in Hobart who was investigated by AHPRA for almost five years, said medical professionals were also harmed by the investigation process.
“The cost to me has been enormous,” he told 7.30.
“It’s been all consuming for the best part of five years now, and it still hasn’t finished.”
Dr Fettke, an advocate of a low-carbohydrate diet, was pursued for telling his patients to avoid sugar. The complaint was made by a dietitian, not his patient.
He was eventually exonerated and received an apology for the way he was treated during the investigation, but he said he knew hundreds of health workers who felt persecuted.
“Virtually everyone who goes through the process seriously considers stopping their career … I’ve certainly considered that,” he said.
“I know of many others, hundreds, who are in the same process.”
‘It says it’s doing all of this work to fix it, and it never does’
Mr Gardner believes he was managed out of AHPRA for raising too many concerns, and his is currently suing it for constructive dismissal.
He is also acting for practitioners who are being investigated by the watchdog.
He said an organisation like AHPRA was vital for public safety, but he was sceptical about its claims it was going to improve things.
“We all know about how many problems there are there, and AHPRA is very good at talking about how it’s going to fix all of these things, and it’s doing all of this work to fix it, and it never does,” he said.