06 October 2013

Health Practitioner Vetting

The Australian Health Practitioner Regulation Agency (AHPRA) is conducting a further public consultation [PDF] on international criminal history checking.

The APHRA consultation paper seeks feedback on options for refining international criminal history checks used in assessing applications for registration for the 14 health professions regulated under the Health Practitioner Regulation National Law, ie
  • Aboriginal and Torres Strait Islander Health Practice Board of Australia
  • Chinese Medicine Board of Australia
  • Chiropractic Board of Australia
  • Dental Board of Australia
  • Medical Board of Australia
  • Nursing and Midwifery Board of Australia 
  • Medical Radiation Practice Board of Australia
  • Occupational Therapy Board of Australia
  •  Optometry Board of Australia 
  • Osteopathy Board of Australia 
  • Pharmacy Board of Australia 
  • Physiotherapy Board of Australia
  • Podiatry Board of Australia, 
  • Psychology Board of Australia. 
Section 79 of the National Law provides that before deciding an application for registration, a National Board must check the applicant’s criminal history, with the Board being authorised to  obtain a written report about the applicant's criminal history from
  • CrimTrac;
  • an Australian  police commissioner;
  • an entity in a jurisdiction outside Australia that has access to records about the criminal history of persons in that jurisdiction. 
The vetting poses questions about spent convictions, fraud (several practitioners with serious overseas offences have massaged their CVs) and criminalisation of political activity in some nations.

Criminal history is defined in the National Law as:
a) every conviction of the person for an offence, in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law;
b) every plea of guilty or finding of guilt by a court of the person for an offence, in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law and whether or not a conviction is recorded for the offence;
c) every charge made against the person for an offence, in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law. 
The word ‘offence’ is not defined in the National Law and has its ordinary meaning of ’a breach of the law’.

The current approach to checking criminal histories involves:
1. seeking an Australian criminal history through CrimTrac and
2. requiring the applicant to sign a declaration on the registration application form disclosing their criminal history in all countries, including Australia. ;
In cases where applicants declare that they have no criminal history outside Australia; no further evidence, audit or authentication is currently required, nor sought. Further investigation takes place in instances where applicants declare a criminal history,  with that history being assessed according to the relevant Board’s Criminal history registration standard.

AHPRA and the National Boards have been considering "possible ways to refine the mechanisms for international criminal history checks", balancing requirements for public protection with the need for "responsive and timely application and assessment processes for health practitioners seeking registration in Australia". In the initial consultation there were four options -
1: Applicant declaration only
2: Applicant provides criminal history clearance evidence with application
3: AHPRA obtains clearance/information from jurisdictions outside Australia when processing application
4: Applicant makes declaration and AHPRA undertakes random sample audit 
Following disagreement evident in the small number of responses to the initial options AHPRA has sought comment on a new option (option 5), involving conduct of  international criminal history checks by an external provider with demonstrated expertise in employment screening, including international checks.

AHPRA argues that option 5
would establish a similar process for checking international criminal histories to the current process for checking domestic criminal histories through CrimTrac. It would strike a reasonable balance between risk, undertaking comprehensive checks where appropriate and not imposing unnecessary delays on applicants becoming registered.
The applicant would be required to meet the cost of the international criminal history checks. Existing general requirements would continue to apply (every applicant to undergo a domestic criminal history check, make a declaration about their criminal history and arrange the provision of Certificates of Registration Status from every jurisdiction where they have been registered). 
The option would involve the following aspects -
  • AHPRA would tender to identify a provider with expertise in international criminal history checking.
  • All applicants would continue to have an Australian criminal history check before registration.
  • An international criminal history check would also be done for any applicant who declares that they have lived in a country other than Australia for a specified period of time when 18 years of age or older.
  • A check would be done on each country where the applicant has lived a specified period of time when 18 years of age or older.
  • The check would apply to the applicant’s entire criminal history (there will be no time limit on the check).
  • The check would be done after the applicant is registered. The period between granting registration and the completion of the check would be covered by the applicant making a declaration about their international criminal history.
  • The applicant would pay the cost of the international criminal history checks required plus an administration fee.