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The Regulation Debate – What It Means For You (Audiology Australia)

May 8, 2024

By Leanne Emerson, CEO, Audiology Australia

 

In Australia, the oversight of allied health professions is undertaken in one of two ways – Ahpra registration or NASRHP self-regulation. Which camp a profession belongs to is dependent on a range of factors we are exploring on our website. Both options have strengths and challenges, and many similarities when it comes to compliance, protections, quality control and ensuring standards of care. Ultimately the decision is not ours to make, but it is important for the profession and its members to be clear on what the choice of registration or self-regulation means for audiology and its future.

To give some context to the question of audiology regulation, Ahpra is regulated by the National Registration and Accreditation Scheme (NRAS) and the requirements of the Health Practitioner Regulation National Law. Individuals in these sixteen professions must register with Ahpra to practice in a regulated health profession. Ahpra registration is decided by the Federal Government based on set criteria which specifically include “risk”.

For those in camp ‘self-regulation’, the process is different but no less rigorous.  Audiology Australia is a member of the National Alliance of Self-Regulating Health Professions (NASRHP), which sets evidence-based minimum practice standards for health professions which meet the requirements of membership. NASRHP standards closely align with Ahpra registration, standards and both provide nationally consistent oversight of quality, including compliance with a code of conduct, and consumer safety.

Both options work effectively to address scope of practice, competency standards, practitioner certification requirements and CPD, as well as notifications or complaints. Neither, however, provides industrial or business advice, or a mandate on how an organisation or health service should conduct its operations. These gaps are important to consider when debating registration.

 

Registration and Audiology Australia

Audiology Australia is not and has never been against the profession achieving registration and we continue to raise the issue with Government. To date the response has remained the same – it is a low-risk profession and doesn’t meet the six criteria for registration.

Whatever the Government’s position is on regulation, it doesn’t change the need to have this important discussion or spell the end for continued advocacy.

 

Where to from here?

Our role is to represent the best interests of our members – YOU. To do that, we need to fully understand the benefits and disadvantages of registration in line with our needs now and into the future.

The arguments are complex and nuanced.  For example, any decision to regulate the profession will likely involve both audiology and audiometry and if it doesn’t, what does that mean for businesses which employ both professions?  Other misnomers include that registration will provide a vehicle for addressing (perceived or real) unethical practices by businesses, simplify HSP processes, or regulate the processes and structures in primary care. The exploitation of Medicare and other systems still occurs for Ahpra registered professions as seen recently1. It is important to understand that Ahpra  regulates individual practitioners, not health care systems or business practices,

It is also important to understand that some real consequences come with registration that may not serve our members well.  It is essential members have accurate, objective, and complete information about our current regulatory environment, the regulatory environment under NRAS (Ahpra) and options in-between.  The advantages that regulation may offer audiology, title protection, increased profile and improved access to referral and prescribing rights can also be achieved outside of the Ahpra model.

Recent incidents in paediatric audiology have added additional context to this issue and sparked renewed discussions about suitable protections for consumers into the future. The independent reports around each set of incidents, point to wider, systemic failings across the health sector as the significant contributing factors.  It is insufficient and inadequate to point only to the issue of registration as a remediation to this issue. Indeed, if we look at regulation of any kind, self-regulation, regulation under Ahpra, specialist regulation, jurisdictional regulation, none of these adequately solve the problem.  If the profession and the respective governments are serious about preventing a repeat of these incidents, we need system solutions to a systemic problem.

 

Making sense of the problem – a national conversation

In a significant step towards understanding this complex issue, State and Territory Health Ministers have opened a targeted consultation to inform a Decision Regulatory Impact Statement (Decision RIS). This will consider regulatory and non-regulatory options for the future of the audiology profession There are various options they have deemed as in scope for the review including:

  • National Registration and Accreditation Scheme (Ahpra) registration
  • Regulation specific to audiologists that perform paediatric diagnostic and cochlear implant care services
  • The status quo – certification under the National Alliance of Self-Regulating – Health Professionals (NASRHP)
  • Jurisdictionally based regulation of the profession

The review is being led by Queensland Health, and we understand the review will consider impacts to both audiology and audiometry.

We have compiled a range of views to help you understand NASRHP (for self-regulating professions) and NRAS (Ahpra) and enable you to distinguish fact from fiction. Elle Hoskins, the AudA Policy and Advocacy Manager, details the pros and cons and her experience in the Ahpra policy team adds a fresh set of eyes to the conversation for audiology.  We also include perspectives from outside the profession and the organisation to ensure objectivity and allow you to form your own opinions. I encourage you to delve beneath the rhetoric and propaganda that too often drive this conversation and learn to understand what is important to you in each model.

You’ll be able to stay up to date on this issue and latest developments on our dedicated webpage here.

References

    1. https://www.abc.net.au/news/2024-05-01/medical-bills-reveal-fraud-and-exploitation-of-medicare/103784522

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