Reinstatement of Previously Deregistered Health Professionals in Australia: Legal Determinations of Risk, Patient Safety, and Public Interest

Abstract

Each year approximately 60 registered health practitioners in Australia have their registration cancelled for reasons of serious misconduct or, less commonly, impairment or criminal conviction. Cancellation remains in force unless the practitioner successfully brings a later application to be restored to the register. While the decision to deregister takes place in a public tribunal process, with published reasons, throughout most of Australia determinations concerning reinstatement are undertaken by professional Boards in private. This research examines available reinstatement decisions concerning 86 health practitioners to analyse how the health regulatory system in Australia determines questions of public interest and public safety when deciding whether deregistered health practitioners who seek reinstatement are now ‘fit and proper’ to practise their profession again. There is a considerable body of case law on the meaning of fitness to practise for health professionals, and the process by which it can be assessed. However, there is remarkably little legislative content or administrative guidance to structure the reinstatement inquiry, assist applicants in the process or to ensure consistency of decision-making, in particular by drawing attention to broader public protection factors. Reinstatement determinations would be improved through the introduction of structured guidance on how to apply the paramount objective of public protection. The article also suggests that having all reinstatement determinations take place in public with published reasons would improve public understanding of, and confidence in, the reinstatement process.