In 2010, Australia took an unprecedented step forward in its nationwide approach to health care regulation. In response to concerns over its system’s inflexibility as well as a surge in natural disasters and a series of well-publicized regulatory failures, the Australian government chose to consolidate 34 separate agencies across its states and territories into one governing body: the Australian Health Practitioner Regulation Agency (Ahpra).
Today, Ahpra oversees 16 different health professions across Australia. As a centralized regulatory body, the agency allows for license portability throughout the country, empowering health professionals to move freely between states and territories for their own needs or for the needs of a jurisdiction. It stands in stark contrast to systems like the U.S., in which each state generally has its own unique licensure standards that limit interstate mobility.
At the helm of Ahpra is CEO Martin Fletcher, who has been working on the agency’s creation and implementation since December 2009. Before Ahpra, Fletcher served as chief executive of the National Patient Safety Agency in England and Wales. He has also worked with the Work Health Organization in Geneva as well as the Australian Council for Safety and Quality in Health Care, where he helped to establish the first national work program for patient safety.
In a wide-ranging discussion with Ascend Magazine Editor Paul Leavoy, Fletcher details the creation of Ahpra and the unique challenges associated with such a drastic shift toward centralization, touching on the lessons to be learned from Australia and other countries as regulators everywhere push to even out professional distribution and adapt to a rapidly changing world.
“Regulation needs to continue to evolve,” according to Fletcher. “For example, one of the things we’ve done is continue to get amendments to our legislation, to continue making it fit for purpose and also to ensure it’s relevant to where we are now.”
He also discusses the impacts of COVID-19 on health care regulation, the management of sexual boundary violations in health care, the use of data to inform risk-based regulation, and more. Want to learn more about the important work Fletcher has undertaken over the past two decades? Check out these resources:
- “A step towards evidence-based regulation of health practitioners,” a research paper co-authored with Dr. Marie Bismark (a fellow Ascend Radio guest).
- Fletcher’s work (via Ahpra) on investigator training with the Council on Licensure Enforcement & Regulation (CLEAR).
- His 2016 article in the Journal of the Consumers Health Forum of Australia on the state of health regulation at large.
