Health Practitioners Ombudsman ‘Immeadiate Powers’ Review
Friday 28th March 2025
Dr. Christopher Maclay
MBBS, FRACGP
To the National Health Practitioners Ombudsman
Introduction
I submit this report to highlight the misuse of the Australian Health Practitioner Regulation Agency (AHPRA). AHPRA’s immediate action powers lack of safeguards for healthcare practitioners.
The powers are currently too broad, poorly defined, and lack essential safeguards.
My personal experience exemplifies these flaws: I was subjected to immediate action despite no patient complaints or harm, minimal time to respond, and ongoing lack of transparency. These issues erode trust in AHPRA, worsen the medical workforce crisis, and ultimately harm patient care.
Rather than enhancing patient safety or encouraging compliance, these actions create an environment of fear, discourage engagement with AHPRA, and contribute to the worsening retention crisis in Australia’s medical workforce.
Lack of Procedural Fairness and Due Process
AHPRA’s immediate action powers are exercised in a manner that is neither just nor transparent. In my case:
I was notified by AHPRA in February 2024 of a complaint made by the TGA. No patient complaint or harm was alleged. I received no other contact until August 2024.
In August I was contacted by AHPRA informing me they intended to take immediate action against me to safeguard the public. The supporting material had over 2500 pages, and I was allowed 2 full business days to respond. The immediate action supporting material contained significant factual errors, including legal misclassifications of medicines and mathematical mistakes (e.g., confusing 600 with 60).
I have not been contacted by the AHPRA ‘investigator’ at any time before or after this.
Seven months later, the immediate action imposed remains in place, effectively preventing me from practicing medicine. I have received no further information, questions, or contact from AHPRA or the investigator.
Conditions were imposed on my registration despite no patient complaints, no evidence of harm, and no proper consideration of my response.
My legal advice was to wait for the AHPRA investigation to complete before challenging, if necessary, in the Tribunal, effectively incapacitating me.
These practices reflect an arbitrary and biased use of power that lacks fundamental procedural safeguards. Immediate action should be reserved for cases where there is a demonstrable and imminent risk to patient safety. Instead, it is being wielded pre-emptively and punitively, disregarding the principles of natural justice.
Impact on Professional Practice and Well-being
The imposed conditions have had devastating consequences on my career, my patients, and my personal well-being:
I have been unable to continue caring for my patients, disrupting their treatment and continuity of care.
My professional reputation has been severely damaged, despite the absence of any patient complaints or harm.
The emotional and mental toll of being placed under investigation without due process has been profound, compounded by the uncertainty of an indefinite restriction.
The conditions have no clear resolution timeline, leaving me in professional limbo with no defined pathway to reinstatement.
I am unlikely to return to clinical practice as a GP in Australia after this experience.
This approach contradicts AHPRA’s mandate to protect public safety. By removing practitioners from practice through flawed and unjust means, patient care is not improved—it is significantly disrupted.
Erosion of Trust in the Regulator
AHPRA’s inconsistent and heavy-handed use of immediate action powers discourages transparency and cooperation among healthcare professionals. The lack of clear guidelines, accountability, and oversight fosters an adversarial rather than collaborative regulatory environment. As a result:
Practitioners are increasingly fearful of engaging with AHPRA, leading to defensive medicine and reluctance to take on complex cases.
The healthcare workforce is being diminished as practitioners face career-destroying interventions without justification.
The medical profession is losing faith in AHPRA as an impartial regulator committed to fairness and justice, as demonstrated by surveys conducted by AHPRA.
Defensive medicine, which is known to worsen efficiency, innovation, and patient outcomes, is becoming more prevalent.
These failings contribute to the broader crisis in medical workforce retention.
Recommendations
To restore trust in AHPRA and ensure its regulatory function is exercised appropriately, I urge the Ombudsman to consider the following reforms:
Stricter Criteria for Immediate Action: Immediate action should only be applied in cases where there is a demonstrable and imminent patient risk, with a clear burden of proof on AHPRA.
Adequate Response Time for Practitioners: A minimum response period of 10 business days should be required before immediate action decisions are made.
Mandatory Investigator Engagement: Investigators should be required to communicate with practitioners before proceeding with immediate action, allowing for clarifications and avoiding assumptions.
Time Limits on Immediate Action Restrictions: Immediate action restrictions should be limited to one month. After this period, AHPRA must review the case, justify any extensions, and allow the practitioner to respond before continuing restrictions.
Responses to Inquiry Questions
Do you think AHPRA and the National Boards handle matters where a health practitioner is subject to immediate action in a timely way?
No. Without any patient complaints, I have been waiting seven months since the imposition of immediate action powers without any meaningful communication from AHPRA or the investigator.Are you aware of any barriers to the timely finalisation of a matter where a practitioner is subject to immediate action?
Yes. AHPRA has the power to compel compliance with its investigation and orders. The primary barriers appear to be internal inefficiencies within AHPRA, including staffing and expertise.Do you think improvements are needed to ensure matters are handled more quickly when a practitioner is subject to immediate action?
Yes. Immediate action powers should be time-limited to one month, requiring AHPRA to review and justify any continuation. If AHPRA claims an imminent public risk, it must also dedicate resources to a timely investigation.Do you think health practitioners are treated fairly when they are subject to immediate action?
No. I was given only two business days to respond to a 2,500-page document. Seven months later, I have received no further contact. I believe my response was not seriously considered, and immediate action was imposed as a foregone conclusion.Do you think there are sufficient procedural safeguards for health practitioners who have had immediate action taken against them?
No. Clearly there are not. As a minimum the show cause process should mandate a minimum of 10 days to seek legal advice and prepare a response. The tribunal appeal process is important, but the appeal within 28-day limit is unnecessary. The threshold of evidence required to impose immediate action does not justify indefinite restrictions, nor the financial impositions upon the practitioner of compliance with the orders.Do you think reforms or additional procedural safeguards are needed for practitioners subject to immediate action?
Yes. Immediate action powers must be time limited. If AHPRA cannot substantiate an imminent risk within one month, it must engage with the practitioner and justify any continuation of restrictions. Investigators should also be required to communicate with practitioners before taking immediate action. Sufficient time must also be allowed for practitioners to prepare a response.
Conclusion
AHPRA’s immediate action powers are poorly defined, overly broad, and lack essential protections for practitioners. Additionally, AHPRA appears to misuse these powers to coerce and intimidate. The consequences extend beyond individual practitioners, undermining the integrity of medical regulation in Australia.
The current system does not promote patient safety or professional compliance. Instead, it fosters fear, injustice, and distrust. I urge the Ombudsman to implement meaningful reforms that restore fairness, transparency, and trust in AHPRA’s regulatory role.
Dr. Christopher Maclay
MBBS, FRACGP