NSW Govt Response To ‘Cosmetic Complaints’ Inquiry

The NSW Government has formally responded to the 16 recommendations contained in the report of the NSW parliamentary health care complaints committee inquiry into ‘cosmetic health service complaints in NSW’.

In February 2018 the Parliamentary Committee of the NSW Health Care Complaints Commission (HCCC) resolved to conduct an Inquiry into cosmetic health service complaints in NSW ‘in response to concerns raised by the Minister for Health, the HCCC, the media and the community’ to investigate whether ‘the HCCC and other Government regulatory frameworks could improve outcomes for the public who use cosmetic health services’.

The Committee received 25 formal submissions and held two days of public hearings in August 2018, before delivering its Report – including 16 Recommendations – in November 2018.

The NSW Government tabled its formal response to those 16 Recommendations in June 2019 (see accompanying box) including details surrounding three particularly controversial issues:

  • Title ‘Cosmetic Surgeon’: whether the use of the title ‘cosmetic surgeon’ should be restricted – the COAG Health Council ‘will be considering any needed legislative action’ arising out of a consultation paper on this subject in the second half of 2019, and ‘depending on the outcome of the COAG Health Council processes, the Minister for Health and Medical Research will consider whether any changes should be made to NSW specific legislation’.
  • IPL and Laser Devices: in respect of the regulation of the use of IPL devices and laser devices for cosmetic and beauty services, in NSW the regulation of radiation (which would include IPL) ‘is generally administered by environmental authorities’ and in December 2018 the Australian Health Ministers’ Advisory Council ‘agreed to refer the issue of the regulation of IPL and laser devices to the Australian Radiation Protection and Nuclear Safety Agency’.
  • Non-Registered Practitioners: the NSW Ministry of Health and NSW Fair Trading ‘will consider whether cosmetic health services provided by non-registered health practitioners should be subject to a ‘cooling off’ period’.

Terms of Reference

The Inquiry’s ‘Terms of Reference’ were: That the Committee on the Health Care Complaints Commission inquire into and report on the regulatory framework for complaints concerning cosmetic health service providers in NSW, with particular reference to:

  • The roles and responsibilities of the HCCC relative to the roles and responsibilities of Commonwealth and other state regulatory agencies;
  • The adequacy of the powers and functions of the HCCC to improve outcomes for the public in the cosmetic health services sector;
  • The opportunities for collaboration with other agencies, organisations and levels of Government to improve outcomes for the public in the cosmetic health services sector; and
  • Any other related matters.

Submissions & Hearings

The Committee received 25 formal submissions, which were published on the NSW Parliament website (www.parliament.nsw.gov.au/committees/inquiries).

Subsequently the Committee held two days of public hearings in August 2018, where representatives of 18 groups gave formal evidence: Australian Society of Plastic Surgeons, Australasian Society of Aesthetic Plastic Surgeons, Royal Australasian College of Surgeons, Australasian College of Dermatologists, Australian Medical Association, Australian Lawyers Alliance, Law Society of NSW, Australian College of Nursing, Trusted Surgeons, Cosmetic Physicians College of Australasia, Australasian College of Cosmetic Surgery, Nursing and Midwifery Council of NSW, Medical Council of NSW, Australian Health Practitioner Regulatory Agency, Australian Department of Health, NSW Health, NSW Fair Trading, NSW Health Care Complaints Commission.

Final report & recommendations The Committee tabled its final Report, including 16 formal Recommendations, in November 2018.

Committee Chair Adam Crouch summed up: ‘The Inquiry considered whether the HCCC and other government regulatory frameworks could improve outcomes for the public who use cosmetic health services.

‘The Inquiry was also a response to a growing public concern with regards to this industry.’

Crouch noted the key findings included Committee gaining an understanding that ‘the regulatory environment relating to cosmetic health services is incredibly complex, but also dynamic.

There are a number of state and commonwealth laws and organisations with regulatory and complaint-handling functions, but there is no set definition of cosmetic health service – so both registered and unregistered practitioners work in this area.’

He said the Committee ‘was also very concerned to hear that there were many instances of under-reporting of complaints about cosmetic health services for various reasons. We know this is a growth industry and there are concerns about the ‘corporate model’ of practice versus the traditional model of patient-centred care.’

Crouch said the Committee was particularly concerned about ‘instances of pro ts being put before patients by some providers’.

He said the Committee also found ‘collaboration between the HCCC and other state and commonwealth organisations is important to inform and protect the public’ and equally important that ‘this collaboration continues in the strongest possible way.’

Crouch added that while the Committee ‘mostly received evidence from and about registered practitioners’, it considered
the ‘regulation of unregistered practitioners could be the subject of a separate Inquiry’.

Major recoMMendations In highlighting what he described as the major recommendations, Committee Chair Adam Crouch commented: ‘The Committee recommended a review of the HCCC’s powers and functions to ensure that the HCCC is able to protect patients using health services, and assist in resolving their concerns.’

Of particular focus, he highlighted that the Committee recommended ‘the title ‘cosmetic surgeon’ be restricted or protected nationally, or at the very least in NSW, so doctors using this title meet certain minimum criteria in terms of education, training and experience.

Crouch explained the Committee ‘heard that at present a range of doctors may use this title – from GPs to plastic surgeons – and this can potentially mislead the public’.

Crouch added the Committee also heard that the public ‘needs to be better informed about cosmetic health services procedures and practitioners, and the complaints process itself. The Committee has recommended a public awareness campaign and
a ‘one-shop-stop’ website and advice service to ensure the main demographics using these services are very well informed.’

Anticipated Outcomes

In summing up the Committee’s ‘anticipated outcomes’, Crouch said it hoped the recommendations ‘will ensure the HCCC’s powers and functions are robust enough to adequately address the complexities associated with the cosmetic health services industry and assist patients in resolving their concerns.

In addition, the Committee sought ‘a stronger legislative and regulatory framework to better protect the public from potential harm and, of course, a public that is better informed about the risks of cosmetic procedures, the types of practitioners performing them and ‘where and how’ to make a complaint if they are dissatisfied.’

Crouch concluded his summary: ‘The one thing that’s come out of this Inquiry is the fact that the HCCC is there to help the public.’ AMP