Health
textual image stating 'Department of Health, Victoria, Australia'
Contact

Hospital Circular 07/2009

Date Issued: 6 March 2009

Distribution: Public Hospitals, Private Hospitals and Multi Purpose Services

Subject: Policy regarding professional misconduct

Purpose: To advise health services (including public hospitals, private hospitals and multi purpose services) of their obligations when recruiting, managing or credentialling and defining the scope of clinical practice of employees/appointees who are registered health practitioners under the Health Professions Registration Act 2005, and who have engaged in conduct that may be defined as ‘professional misconduct’ under that Act.

Background

  1. There have been a number of cases nationally where public health and safety has been compromised in part because health services have:  

    1. failed to carry out sufficiently rigorous checks on applicants for employment or during credentialling; or

    2. cancelled or curtailed the scope of clinical practice of a registered practitioner or terminated their employment due to concerns about their competence or conduct and failed to inform the relevant registration board or another employing health service seeking referee reports.

Recruitment and appointment of health practitioners

  1. Prior to employing or appointing a health practitioner from one of the registered health professions, the health service must verify with the relevant registration board the practitioner’s registration status and obtain information on:

    • any conditions or restrictions imposed on the practitioner’s registration; and

    • any matters referred to VCAT or equivalent State tribunal in relation to the practitioner, whether they be in progress or completed in relation to the practitioner.

  2. In relation to registered medical practitioners who apply for appointments that involve independent responsibility for patient care, public health services are required to comply with the policy, Credentialling and defining the scope of clinical practice for medical practitioners in Victorian health services. Specifically, all health services, apart from a Police Check, must:
    1. request of applicants for credentialling the following information:

      • a declaration regarding any denial, suspension, termination or withdrawal or restriction of the right to practise (other than for organisational need and/or capability reasons) in any other organisation;

      • a declaration regarding any prior disciplinary action or professional sanctions imposed by any registration board or similar body both in Australia or overseas;

      • a declaration regarding any criminal or civil investigation or conviction or finding of guilt with or without conviction in Australia or overseas;

      • a declaration regarding the presence of any physical or mental condition, incapacity or substance abuse problem that could affect the medical practitioner’s ability to exercise the requested scope of clinical practice;

      • details of three independent professional referees, preferably at least two in the applicant’s own specialty, who have been in a position to judge the applicant’s qualifications and experience during the previous five years and who have no conflict of interest in providing a reference; and

      • written consent for the committee and/or organisation to verify with any relevant individuals, external organisations and nominated referees the validity of all claims made;

    2. ensure the applicant’s credentials are verified and obtain proof of qualifications, indemnity insurance, medical registration and any other relevant information;

    3. obtain references from at least two referees, preferably within the specialty being applied for, what are independent of the applicant with no conflict of interest, and who can attest to the applicant’s professional performance with in the previous three years.

    4. Any resulting contract of employment or service must ensure there is an obligation on the health practitioner to declare

      • any withdrawal or limitation on their registration during their contract or period of employment

      • any investigation by a registration body or other authority including insurers and

      • any investigation, withdrawal or limitation on scope of clinical practice instituted by another employer or service provider.

Performance management and notifications to registration boards

  1. While health services are responsible for the performance management of all employees/appointees who provide care for patients, health services are also under an obligation to report certain matters relating to registered health practitioners to the relevant registration board, particularly where an employed or appointed registered health practitioner engages in conduct that might constitute professional misconduct as defined under section 3 of the Health Professions Registration Act 2005. 

  2. Professional misconduct as defined under the Act includes:  

    1. conduct that involves a substantial or consistent failure to reach or maintain a reasonable standard of competence and diligence;

    2. conduct that violates or falls short of, to a substantial degree, acceptable professional standards;

    3. conduct that would justify a finding that the practitioner is not of good character, whether this conduct occurs in connection with the practice of the health practitioner's health profession or occurring otherwise than in connection with the practice of a health profession.

  3. Without limiting the circumstances under which a health service might make a notification to a registration board, health services must make a notification under section 42 of the Act in circumstances where:

    1. the health service management is made aware of allegations that:

      • a practitioner has engaged in sexual misconduct; or

      • a practitioner has been working while intoxicated with drugs or alcohol or with a significant degree of cognitive impairment or untreated mental illness; or

      • a practitioner has accepted inducements to use certain medical products, order certain diagnostic tests or  refer patients to certain services, thereby compromising their responsibility to act in the best interests of their patients; or

    2. the internal performance management or other quality systems of the health service have identified a practitioner with an ongoing  pattern of poor performance who has not responded to or complied with remedial strategies; or

    3. the employment or appointment of the registered health practitioner has been terminated due to concerns about their competence or conduct.

  4. Confidentiality clauses prohibiting disclosure of information to a responsible board must not be included in any future contracts of employment or service or any arrangements that health services enter into with registered practitioners.

  5. In the event that a health service is uncertain about whether allegations against a registered health practitioner may fall within the definition of ‘professional misconduct’ under the Act, the health service should contact the responsible board to seek advice and act on that advice.

Peter Allen
Under Secretary
Portfolio Services and Strategic Projects

Back to top