The sacred creed of ‘do no harm’ has been cast aside by health professionals according to a six-month investigation by the ABC’s Four Corners.
Australian healthcare has been rocked by the astounding allegations aired by Four Corners on 6 February 2023, that almost 500 health practitioners have been sanctioned for sexual misconduct involving patients since 2010.
And concerningly, more than 160 are still working in healthcare today.
Over a period of six months journalist Emily Baker and her team reviewed a decade of published disciplinary decisions handed down by AHPRA and state-based tribunals, examining over 1,000 documents , to try and determine just how many health professionals have been disciplined for sexual misconduct.
They discovered that:
- Four convicted paedophiles and a convicted rapist are still registered as doctors
- Nearly 500 practitioners with findings against their name related to sexual conduct involving patients
- Almost 200 health workers who have been disciplined for related matters outside their direct practice, for example, sexually harassing colleagues
- Doctors make up just 15 per cent of all registered health workers, but they account for almost half of those disciplined for sexual misconduct
- More than one-third of all publicly disciplined practitioners are still on the national register
During the program, Professor Marie Bismark, from the University of Melbourne, said that for every one in five allegations of sexual misconduct against a health practitioner, there was another incident that occurred within five years.
“There is a small minority of practitioners who engage in this misconduct but every one of these cases has profound implications, it has profound consequences for that patient, for their medical care and for their trust in the healthcare system,” Professor Bismark said.
“It also affects the health practitioner and their colleagues.”
Professor Emeritus Merrilyn Walton, the former head of the NSW Health Care Complaints Commission (HCCC), said that there is no place for sex in the relationship between a doctor or health practitioner and their patient – “it is a gross abuse of trust.”
“The doctor patient relationship depends on trust, who else do we go to where we will undress when we are asked to, allow them to touch us in intimate places when they want, ask us questions about the most intimate things in our life? And we give them answers about those intimate spaces,” Professor Walton said.
“Nowhere else does that happen in professional relationships – that trust is fundamental to our wellbeing.”
Conditions can be imposed when a person is under investigation, allowing them to keep working until findings of fact are made, but sometimes, tribunals impose restrictions around treating men, women, and certain age groups even after a serious complaint is upheld, instead of revoking or suspending the practitioner’s registration.
For example, a GP convicted of digitally raping a patient and separately reprimanded by the Medical Board for “inappropriate conduct” with seven other female patients was given the all-clear to return to work on the condition he did not treat women or people under 16.
He continues to work today, and the claim was repeatedly made, that if a teacher is not appropriate with female students, you do not send them to an all boy’s school – they are not fit to be a teacher.
In most states and territories, the reasons why a healthcare professional has been allowed to return to practise after losing their registration for serious wrongdoing are not made public and the program highlighted that there are 49 separate bodies handling complaints around the country – no one person or agency has ultimate authority.
Ahpra, set up in 2010, can investigate complaints but can only recommend disciplinary actions, which are limited to placing operational conditions upon practitioners such as mandatory education on professional boundaries, and the effectiveness of these measures have never been independently tested.
“I am not aware of any public research as to whether the conditions that are being used (by Ahpra) are effective or not, and I think there is an urgent need for that research to be done, Professor Bismark said.
“[We have] to look at the allegations of sexual misconduct that have come forward and to see whether there has been repeat offending by those doctors, so that we can understand which types of conditions are working, and for which types of practitioners.”
Ahpra’s CEO, Mr Martin Fletcher, said there are sometimes tribunal decisions “where we have been disappointed,” but believed that recent amendments to health regulation laws could result in fewer such outcomes.
“I completely understand that there are people in the community that would believe that there’s certain behaviour that should mean you should never be registered as a health practitioner again,” Mr Fletcher said.
“I think transparency and regulation is a really important thing, not just in this context but more widely… and I think that is a debate to have in the community.”
Mr Fletcher said he supports making the process public but stressed that laws would have to change to allow that, and for the first time Ahpra is publicly endorsing legislative change to support greater transparency.
When Four Corners sent its findings to Federal Health Minister Mark Butler, he called for a rapid review of whether recommendations from previous reviews had been promptly implemented.
“If that framework is falling short of protecting patient safety, then Australians rightly expect governments at all levels to work to strengthen it,” Minister Butler said, noting that most health professionals deserve patients’ trust.
“But where practitioners abuse it, regulators must step in.”