The Australian Health Practitioner Regulation Agency (Ahpra) and Medical Board of Australia (MBA) have announced an “external review of patient safety issues in the cosmetic sector”.
The review, led by outgoing Queensland Health Ombudsman Andrew Brown, will:
- include how to “strengthen risk-based regulation of practitioners”;
- ensure “our regulatory approach keeps pace with rapid changes in the cosmetic surgery industry”;
- make recommendations about “actions that will better protect the public”.
With Australia’s state and territory health authorities currently exercising major regulatory roles in licensing facilities, the review will also examine “how to improve communication and cooperation between agencies involved in the current system of checks and balances”.
The regulators noted cosmetic surgery’s rapid growth as “a multi-million dollar entrepreneurial industry, has given rise to practices and marketing methods by some registered health practitioners which raise significant patient safety concerns”.
AHPRA chief executive Martin Fletcher said: “Some worrying features of the cosmetic industry set it apart from conventional medical practice, including corporate business models which are alleged to place profit over patient safety, no medical need for cosmetic procedures, limited factual information for consumers and exponential growth in social media that emphasises benefits and downplays risks.
“This review will ensure the specific regulatory responsibilities of AHPRA and National Boards are effectively protecting the public in our part of the regulatory system for cosmetic surgery.”
The review will consider the current risk-based regulatory framework of AHPRA and National Boards, including: current codes of conduct; notifications and investigations protocols; and management of advertising offences in relation to cosmetic surgery.
MBA chair Dr Anne Tonkin said the Board was concerned there may be “a weak safety and reporting culture in cosmetic surgery”.
She noted: “It’s a very good thing there are doctors, nurses and other health professionals picking up the pieces when patients’ cosmetic procedures go wrong. But to keep patients safe, we need to understand why these practitioners are not always sharing their patient safety concerns with us in a timely way.
“If we know where the issues are, we can do something about them to keep patients safe.”
Andrew Brown will lead the review when he finishes as Queensland Health Ombudsman in January 2022. Public consultation will begin in early 2022 and the review will report by mid-2022.
Other panel members include: Alan Kirkland (CEO of CHOICE); Professor Anne Duggan (Chief Medical Officer for the Australian Commission for Safety and Quality in Health Care); and Richelle McCausland (National Health Practitioner Ombudsman).
Mr Kirkland commented: “The cosmetic surgery industry has changed enormously since the current regulatory framework was introduced, with procedures now promoted through Instagram and TikTok and available in shopping centres across the country.
“I’m keen to explore whether consumers are being adequately informed about the risks of some procedures and whether regulators have the powers they need to prevent harm.”
Ms McCausland added: “This review is coming at a critical time to ensure there is greater accountability in the regulation of cosmetic surgery in Australia.
“It has been alarming to hear patients and practitioners sharing concerns about patient safety in this industry. My office regularly sees the critical role the notifications process plays in alerting AHPRA and the National Boards of potential risks to patient safety.
“We need to understand how best to reduce or eliminate barriers to people sharing concerns. My hope is this review will give us insight into how regulatory processes can keep pace with changes in the cosmetic surgery industry to best protect the public.”
The review will specifically “inquire and report on”:
- the regulatory role of AHPRA and relevant National Boards in cosmetic surgery with particular attention to its risk-based approach focusing on:
- updates to codes of conduct and supporting guidance which aim to ensure practitioners practise safely within the scope of their qualifications, training and experience;
- methodology for risk assessment of cosmetic surgery notifications;
- the AHPRA investigation protocol;
- the management of advertising offences;
- opportunities for changes, clarifications or further actions to the current regulatory approach to protected titles.
- the way AHPRA works with other system regulators to ensure clear roles and responsibilities and appropriate information flows in support of the broader regulatory framework involving state, territory and national regulators.
- the best means available to strengthen the safety reporting culture within cosmetic surgery to address barriers to health professionals raising concerns when a practitioner has practised in ways that depart from accepted professional standards.
- strategies relevant to the role of AHPRA and National Boards as regulators of registered health professions to reduce information asymmetry for consumers in order to inform safer choices and informed consent.
- provide a contemporary view of current risks to patient safety in cosmetic surgery and how they should inform the work of AHPRA and relevant National Boards.
