Outgoing Qld health ombudsman to lead cosmetic patient safety review

The Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board of Australia (the Board) will review patient safety issues in the cosmetic sector, including how to strengthen risk-based regulation of practitioners in the industry.

This review will consider existing regulation and regulatory practices in use by Ahpra and the relevant National Boards to ensure they keep pace with rapid changes in the cosmetic surgery industry and to make recommendations for any required changes to better protect the public.

Ahpra CEO 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.”

The review will consider the current risk-based regulatory framework of Ahpra and National Boards, including the current codes of conduct, the notifications and investigations protocols, and management of advertising offences in relation to cosmetic surgery.

Medical Board of Australia Chair Dr Anne Tonkin said, “It’s a very good thing that there are doctors, nurses and other health professionals who are picking up the pieces when patients’ cosmetic procedures go wrong. But to keep patients safe, we really need to understand why these practitioners are not always sharing their patient safety concerns with us in a timely way.”

Andrew Brown will lead the review once he finishes in the role of Queensland Health Ombudsman in January 2022. Public consultation will begin in early 2022, and the review will report by mid-2022. Brown has 30 years’ experience in the public sector, primarily in legal services, regulatory oversight and complaints management. He has extensive experience in public administration and designing and implementing effective and efficient regulatory and complaints management processes.

Other panel members include Alan Kirkland, CEO of CHOICE; Professor Anne Duggan, Chief Medical Officer for the Australian Commission on Safety and Quality in Health Care; and Richelle McCausland, National Health Practitioner Ombudsman.

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) argued the review is “too little too late for those who have lost their lives and for those survivors who have had their lives changed forever”.

“Only practitioners who have successfully completed Australian Medical Council (AMC) accredited training can use legitimate approved specialist surgical titles. However, most practitioners who use the title ‘cosmetic surgeon’ are not registered surgical specialists and have not completed AMC accredited training — the Australian standard of training in cosmetic surgery,” said ASAPS in a statement.

Health Ministers have already committed to national consultation on changing the National Lawⁱ to protect the title of ‘surgeon’. Ahpra and the Board welcomed this. State and territory health authorities have a major regulatory role in licensing facilities in which cosmetic surgery is being performed. The review will look at ways to improve communication and cooperation between agencies involved in the current system of checks and balances in cosmetic practice and how the reporting and safety culture of cosmetic surgery can be improved.

“For AHPRA to make genuine, lasting change, they must begin taking preventative steps — rather than waiting for things to go wrong, as they currently do. This could include prohibiting the use of titles that do not directly align with existing AHPRA titles or registration categories and enforcing the obligatory disclosure of a practitioner’s AHPRA registration category,” ASAPS said.

ASAPS President Dr Robert Sheen argued: “The laws exist, they are simply not being enforced. Australia’s health regulator (Ahpra) is not regulating. Any doctor who claims to be a surgeon should do so with Australian Medical Council accredited training and Ahpra registration as a surgeon — it is as simple as that. Ahpra must enforce this.”

The Australasian College of Cosmetic Surgery and Medicine (ACCSM) welcomed the review but insisted on the need for a single national register of cosmetic surgeons.

ACCSM President Dr Patrick Tansley said the current system allowed any doctor to call themselves a cosmetic surgeon and patients could not easily identify whether a doctor had the necessary specific training to be competent and safe.

“Currently, any medical practitioner can call themselves a cosmetic surgeon. Some have received adequate cosmetic surgery training, others have not, which results in a lottery for patients,” Dr Tansley said.

Accreditation in cosmetic surgery by the Australian Government will significantly reduce the number of botched procedures taking place each year, as all practitioners wishing to undertake it will be forced to undergo specific training and demonstrate specific competency in this field of practice before being able to use the title ‘cosmetic surgeon’, Dr Tansley said.

Image credit: ©stock.adobe.com/au/terovesalainen