Peter Arnold: The real cost of national registration

MANY doctors have expressed their dismay at the annoying inefficiency of the Australian Health Practitioner Regulation Agency, based on recent posts in MJA InSight.

Many might generously accept that the new system is overwhelmed by its obligation to take over the registration of hundreds of thousands of health professionals.

But how many appreciate the philosophy underlying this new initiative by Labor governments in Australia?

Or that this new bureaucracy emanates from the workforce considerations of the Productivity Commission?

Productivity and medical practice are not familiar bedfellows.

Does medical practice even lend itself to the notion of productivity?

How can the concept be applied to the management of patients and their illnesses and concerns?

If this is, indeed, a nonsense, then what is the new Authority all about?

For some decades now, Australian governments have been focused on “competition”, whether in banking, manufacturing, wholesaling or retailing of commodities.

“Competition is king” because competition lowers prices.

Competition can also lower prices in health care.

Permitting lesser paid, underqualified people to perform the work presently done by more highly paid, properly qualified people will lower prices.

Even when those people advocate unproven remedies, their services will be cheaper — at least in the short run.

Up until this year, Australia’s eight medical boards, largely independent of government control, were concerned exclusively with standards of medical practice.

They, rightly, had no interest in workforce or in “productivity”.

They have been committed to establishing and maintaining the highest standards of health care.

Now they have been replaced by a government body which has already shown the colour of its cloth by registering chiropractors and which is about to register Chinese medical practitioners, without evidence of the efficacy of these systems of healing the sick.

At the same time, the federal government has established Medicare rebates for services given by nurses, who will be able to prescribe pharmaceuticals and order pathology tests.

Can politicians be so stupid that they do not realise that diagnosis precedes therapy?

How can individuals untrained in diagnosis treat sick people with any degree of professionalism?

The combination of the national recognition of practitioners of unproven remedies and the extension of therapeutic potential to people untrained in diagnosis expose the true motivation behind the establishment of the AHPRA — price-cutting at the cost of high-quality professional health care.

This should not only alarm all doctors, but all Australians.

Dr Peter Arnold is a former Deputy President of the NSW Medical Board, former chairman of the Professional Standards Committee and a former member of the Medical Tribunal of NSW.

Posted 22 November 2010