source : the age
Injured, chronically ill and traumatised patients have accused Australia’s healthcare practitioner watchdog of failing to adequately investigate allegations of gross negligence and misconduct by doctors, nurses and allied healthcare professionals.
Patients and their loved ones who have battled through the Australian Health Practitioner Regulation Agency’s (AHPRA) complaints system will be closely watching the implementation of major reforms over the next five years that were designed to better protect the public and build a safe health workforce.
They described a lack of transparency in AHPRA’s handling of their complaints and why some allegations against practitioners were dismissed without investigation, as well as decision-making by practitioners’ boards to close investigations without further action.
This masthead has spoken to more than a dozen patients who notified the regulator about alleged botched procedures that left them with lifelong disability, unnecessary and invasive treatment, sexual harassment and assaults.
Many received pro forma letters in response to detailed, deeply vulnerable testimonials, and described an alarming lack of trauma-informed communication with AHPRA staff.
Patients’ deep frustration and confusion with the complaints system were catalysts for a major review of the National Registration and Accreditation Scheme, known as the Dawson report.
The Dawson review found that more than one in four investigations dragged on for longer than two years.
“Patients want answers,” said Maddison Teigan*, a patient advocate who has experienced the complaints process firsthand and runs a medical negligence support group on Facebook with about 700 members.
“Why and how does AHPRA make its decisions? How does AHPRA determine what constitutes an acceptable risk to the public? What constitutes action versus no action?”
Maddison said that many patients felt that the Dawson report and AHPRA’s five-year strategy were insufficient and not patient-focused.
Maddison lodged a complaint with AHPRA against a nurse who allegedly violated clinical standards during a blood draw in February 2021, causing nerve damage and triggering a rare, chronic condition called complex regional pain syndrome (CRPS).
The nurse allegedly attempted to draw blood by inserting the needle into Maddison’s right arm, then left and right again. Clinical standards strictly limit attempts to a maximum of two.
Maddison said she withdrew her consent, told the nurse that her actions were causing her pain, and that she needed a break, but the nurse said she knew what she was doing and held Maddison’s arm in place, then bent the needle in different directions inside Maddison’s elbow.
She said she felt a painful sensation similar to an electric shock; the nurse then removed the needle and apologised, stating that she messed up.
“[I was] and still am a shell of myself … I would cry in absolute agony every day, and no painkillers would touch the pain,” Maddison said. “I lost my job as a flight attendant because I could no longer work. I lost all my hobbies … I just lost it all.”
But when the clinic failed to produce the nurse’s provider number, Maddison said AHPRA declined to investigate.
“Apparently there are a few nurses with the same name,” she said.
In 2025, Maddison notified AHPRA again, this time with the nurse’s details and supporting evidence, including a letter from a senior neurologist noting her “history of injury in the region of the median nerve following venipuncture and pain in the arm that has failed to recover”.
AHPRA opened an investigation, but Maddison would eventually receive a letter notifying her that the Nursing and Midwifery Board had closed the case and found “that there is no reason to take any regulatory action”, with no insight into how this decision was reached.
Documents obtained under freedom-of-information laws show that Maddison’s complaint was coded in AHPRA’s internal system as “misconceived, lacking in substance” and that some of the materials Maddison provided were not submitted to the board.
The National Health Practitioner Ombudsman (NHPO) told Maddison that the board appeared satisfied that CRPS can also result from a correctly performed blood draw.
“Implied consent to a blood draw is not the same as informed consent to nerve damage or a lifelong pain syndrome,” she said. “A patient cannot knowingly accept a risk they were never told about.”
A key concern among patients was that AHPRA was primarily funded through practitioner registration and application fees, “meaning those being regulated are also the primary source of revenue, raising concerns about conflicts of interest”, Maddison said.
“The current framework does not adequately prioritise the prevention of ongoing harm where serious harm has happened, and no action is taken,” said Maddison, who launched a petition to federal parliament for an independent inquiry into AHPRA’s governance and complaint handling, and plans to call for a federal royal commission.
In May, Australia’s health ministers ordered AHPRA to immediately improve the timeliness and quality of its investigations and decision-making in response to the Dawson report, which stressed the need to improve AHPRA’s accountability and transparency.
The regulator is tracking its implementation of several recommendations, with a spokesperson saying it was a priority to improve the experience of consumers who raise a notification.
“Our trained staff seek to take a person-centred approach and to support people through the process with care and sensitivity,” the spokesperson said.
“AHPRA assesses each notification and the available evidence on its merits, and its decisions are independent, informed, sensitive and grounded in expertise.”
Insights from the Dawson report
- 25 per cent of active investigations and 21 per cent of active tribunal referrals were unresolved and open for more than 24 months
- Several cases had been open for more than three years
- 85 to 90 per cent of all notifications were closed with “no further action”
- Dissatisfaction with complaints handling was felt “equally deeply” by patients and practitioners
Earlier this year, ABC’s Four Corners revealed that AHPRA had failed to act on complaints from patients about disgraced former gynaecologist Simon Gordon.
The Medical Board of Australia last week referred Gordon to the Victorian Civil and Administrative Tribunal, alleging he engaged in professional misconduct.
An NHPO spokesperson said the ombudsman was “not empowered to stand in the shoes of AHPRA and the national boards to overturn or make an alternative decision”, but could recommend remedies when AHPRA or a national board’s actions were wrong, unlawful or discriminatory, such as recommending the matter be reconsidered.
* Maddison’s surname has been omitted at her request to protect her privacy.
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