Wednesday, March 7, 2012

Health of the nation

What is the state of the health of Australia. No! I am not referring to our economy (although, in comparison to the rest of the world, its in pretty good shape), nor am I referring to our political system ( tho' that probably requires a damn good dose of Geritol and a high bowel enema) and I am not referring to any disease epidemiology (but as an ageing nation, that is a matter of concern).

I am referring to the fact(s) that for the first time in history, Australia is getting a clear picture of exactly how many health professionals are active around the nation. The new national Australian Health Practitioner Regulation Agency (AHPRA) is now the organisation responsible for the implementation of the National Registration and Accreditation Scheme across Australia for all health practitioners. AHPRA's data collection on practitioner registrations is providing the relevant bodies with accurate statistics on the number and disposition of health practitioners.

I commenced my nursing career in 1964, 50 years ago.

In March 2008 the Council of Australian Governments (COAG) agreed to establish a single National Registration and Accreditation Scheme for 10 health professions. It was introduction July 1 2010 with Western Australia joining on October 18.

The ten regulated professions under the national scheme are:

  • Chiropractors
  • Dental practitioners (including dentists, dental hygienists, dental Prosthetists and dental therapists)
  • Medical Practitioners
  • Nurses and Midwives
  • Optometrists
  • Osteopaths
  • Pharmacists
  • Physiotherapists
  • Podiatrists
  • Psychologists

In order to maintain their accreditation all registrants in these professions must keep currency of knowledge and random audits are conducted annually whereby individuals must produce evidence of the professional activities and on-going education through a Professional Development Program (PDP) . It is up to the individual to maintain their own individual PDP, however, in many cases employers assist through annual assessments and PDP Planning sessions.

From July 1st  2012 four additional professions will be included:

  • Aboriginal and Torres Strait Islander Health Practitioners
  • Chinese Medicine Practitioners
  • Medical Radiation Practitioners
  • Occupational Therapists

Here are some selective and interesting statistics:

  • Nursing and midwifery are the professions with the most practitioners with 290,072 registered and enrolled nurses. There are 1,789 registered midwives and 40,234 practitioners registered as both nurses and midwives.
  • Medical practitioners form the second largest group of practitioners behind nurses and midwives, numbering 88,293.
  • Psychologists 29,142
  • Pharmacists 25,944
  • Physiotherapists 22,384
  • Dental Practitioners - Dentists through the whole dental spectrum to Dental Prosthetsists make up  their number of  practitioners of 18,319
One in 44 - or one in every 20 working Australians - is a registered health practitioner. The largest  group of professions is aged 50-54 (14% of total professionals) followed by those aged 45-49 and then 40-44.

Nursing has both the youngest and oldest practitioners of the ten regulated professions proportional to registrant numbers. The typical nurse is female,the largest age cohort being between 50-54 and the largest number of nurses are practicing in New South Wales. Midwifery, however, is the most female dominated of regulated professions with the largest group of midwives 40-44 years and practicing in Victoria.

Along with national registration it is now mandatory to conduct criminal record checks for initial registration through a National Crime Check programme called CrimTrac and a 100 point Identification verification.

Early indications are showing a reduced risk to public safety, however, I have no knowledge as to how this 'risk' is being assessed. 

Applicants for National Registration must disclose any criminal record. It is not an offence to fail to declare any such record, however, such action may result in the National Board taking health conduct or or performance action - or by denying registration.

In 2011-12  AHPRA requested 52,445 criminal record checks. Of those 2,992 (6%) indicated that the applicant had a criminal record. Of these 499 (15%) were assessed has having the potential to effect registration. After consideration by the National Board 40 (9%) of the 449 were assessed as having the potential to effect registration and resulted in action by AHPRA.

A National Crime Check takes approximated 3 to 4 days to conduct, however, it has been found that the younger the applicant the longer the period it takes to check with older applicants being vetted in as little as 3 working days.

For the record, as a retired nurse who remained registered with a State Professional Registration Board, I applied for National Registration under a category known as "Non-Practicing Registration" status. I was asked to show reason why I should be allowed such registration as CrimTrac had pulled up evidence of 'criminal activity' in my history.  

Yes! I was one of the 52,445 checks that reveal 2,992 had a criminal record. Further, I became one of the 499 who were assessed has having the potential to effect registration and I was given a 'Please Explain" request. Those of you who are aware of my wild youthful years will not be surprised at my receiving such a request - but No! - it had nothing to do with my development through my formative years.

It turns out that this 'criminal activity' was a conviction for driving with a low blood alcohol level 36 years ago, an action that resulted in a conviction for driving with more than the Prescribed Concentration of (blood) Alcohol (PCA), which is a 'criminal offence' in Australia. My good driving record was taken into consideration , along with the fact that this was my 'first offence' and I was placed on a restricted licence, with a 'Zero Alcohol level' clause, for 6 months. Needless to say, it was a salutatory lesson and I have never driven while effected by alcohol ever since that time.

I wrote to AHPRA and supplied them details of my offence along with a request to be allowed to remain on the register during my retirement (as this meant I could attend functions and conference with my colleagues and still claim 'Nursing" status) and this request was accepted and granted.

Today I received my National Certification as a "Registered Nurse - Non-practicing".


Cro Magnon said...

Surely, a misdemeanour at the worst. The word 'crime' suggests GBH, Burglary, or worse. In fact I rather approve of being able to check someone's past records.... one never knows!

JohnD said...

Problem is, Cro, all Australian states criminalised 'drink driving' (Exceed PCA) as an offence in order to try to limit an increasing road toll where alcohol was a contributing factor. The 'little fish' get caught in the same net as the incorrigible offenders and you wear the conviction!

It was a very humbling experience, being finger printed, photographed and locked in a holding cell until someone turned up and accepted responsibility for you! Certainly changed my attitude about having a drink and hopping behind the wheel of a vehicle.

JohnD said...

BTW _ I had 'declared' my PCA offence to the State Authority when they began preparing for the switch to a National Registration system. I got a letter telling me not to bother with an offence that happened so long in the past and did not impinge on my abilities to practice as a nurse.

Of course, I could've been a raving alcoholic but they were not interested in following up on this aspect.

North of Wiarton & South of the Checkerboard said...

Drinking & driving is also a Criminal Offense here too in Canada.

"Just Me"

LindaG said...

So the left hand didn't talk to the right hand.
A good chuckle now that you got your certification. Congratulations!

JohnD said...

And so it should be! It's sheer criminal negligence to drink and drive and many accidents, where alcohol was a factor, have caused abject misery to many a family.

JohnD said...

Its amazing that out of 55,000 random criminal checks only 422 cases were worthy of further investigation and only 40 of those warranted further action by the Authority.

I will always wonder if my earlier admission to the State Board, some 10 years previously, prompted my bring selected for a criminal record check by the new National Authority.