NPAA submission: Transforming health practitioner regulation in Australia

We welcome this opportunity to submit to the Queensland Parliament's Health and Environment Committee on the reform of health practitioner regulation.

We note that Queensland, as the host jurisdiction of the Health Practitioner Regulation National Law, carries a unique responsibility to lead structural reform.

This submission does not focus narrowly on the provisions of any single Bill. It is a broader call for the comprehensive transformation of the regulatory architecture governing health practitioners in Australia, a system that has demonstrably failed practitioners, patients, and the public over a sustained period.

Six inquiries, the same failures

Over more than a decade, parliamentary committees have conducted six separate inquiries into AHPRA (2011, 2014, 2016, 2017, 2022, 2025). Each has identified the same systemic failures: vexatious complaints inadequately managed, investigations taking years to resolve, inadequate procedural fairness protections, conflicts of interest in investigative and decision-making processes, suppression of clinical dissent, and a lack of meaningful accountability.

The 2025 Dawson Review, an independent government-commissioned assessment, once again catalogued these failures and recommended urgent reform. The pattern is clear: AHPRA has not reformed itself, and external mandate has not compelled it to do so.

What we asked for

What is required is structural reform: a return to accountable, democratically constituted state-based medical boards, the introduction of self-regulatory frameworks modelled on the Queensland legal profession, legislative amendments to the National Law that protect the foundational principles of informed consent, clinical freedom, and practitioner due process, and the establishment of genuine parliamentary accountability for a regulator that currently answers to no single minister and no parliament.

Our 17 recommendations

1. Return to state-based medical boards, constituted by elected representatives of the profession and accountable to state parliaments, replacing AHPRA's centralised governance model.
2. Adopt a self-regulatory framework for health practitioners modelled on the Queensland legal profession, combining elected professional governance with an independent statutory health ombudsman for serious complaints.
3. Amend the National Law to limit notifications accepted by AHPRA, HCCC and the OHO to clinical issues directly relating to patient safety, excluding practitioner opinion, commentary, and academic expression.
4. Introduce mandatory statutory timeframes for all investigations (assessment: 60 days; investigation: six months standard, twelve months complex), with automatic external review on expiry and compensation rights where no misconduct is found.
5. Amend the National Law to restore the protection of the public as the sole paramount principle, removing “public confidence in the safety of services” as a co-equal ground for regulatory action. Amend the National Law to enshrine protections for informed consent, medical exemptions, and clinical freedom of speech.
6. Create penalties for vexatious complainants, including costs orders and a formal offence for false or misleading notifications. Require a mandatory good-faith statutory declaration from all complainants.
7. Eliminate anonymous complaints, except in cases involving abuse, harassment, or personal safety risk.
8. Require mandatory disclosure and balanced weighing of exculpatory evidence in all investigations and clinical advisor briefings, with written reasons required where contrary evidence is rejected.
9. Establish a levy-funded practitioner support fund providing access to legal assistance and mental health support for practitioners under investigation.
10. Enshrine independent whistleblower protections for practitioners who raise AHPRA, OHO or HCCC governance concerns.
11. Exempt treating practitioners nationally from mandatory reporting obligations, consistent with the Western Australian model, while retaining existing obligations for non-treating practitioners and employers.
12. Require AHPRA’s annual reports to be tabled in every state and territory parliament and referred to a relevant standing committee, with AHPRA obliged to respond in writing to committee findings within 90 days.
13. Mandate that all Immediate Action and disciplinary decisions involve clinical peer review by at least two independent, same-discipline practitioners with no conflict of interest, each providing a separate opinion; where opinions conflict, the practitioner must be informed and given an opportunity to respond before any decision is made.
14. Create a statutory right of review of all notification decisions, including cautions.
15. Require mandatory statutory disclosure of conflicts of interest by all decision-makers and clinical advisors; establish independent oversight of expert advisor selection; and provide practitioners a right to be informed of and to challenge any undisclosed relationship between a decision-maker and a complainant.
16. Introduce income protection for practitioners suspended under Immediate Action provisions where no misconduct is ultimately established.
17. Mandatory Disclosure of International Affiliations. Amend the National Law to require AHPRA to disclose all formal international affiliations, designations, and collaborative obligations, including its designation as a WHO Collaborating Centre for Health Workforce Regulation, to the Health Ministers' Meeting annually, with that disclosure tabled in each state and territory parliament.

The full submission is below.