The risks are generally not realised in practice
|
1
|
PACFA
|
Incorrect labelling/identification of samples
|
1
|
AIMS
|
Significant financial cost for no positive health outcomes
|
1
|
DAA
|
Estrangement, mental breakdown and suicide due to false memory syndrome
|
1
|
AFMA
|
Improper infection control practices have been associated with death and injury
|
1
|
ASAPO
|
Using fraudulent documents to seek employment
|
1
|
ASAPO
|
Theft and sale of medical products
|
1
|
ASAPO
|
Self-medication with controlled and restricted drugs
|
1
|
ASAPO
|
Inappropriate or dangerous uses of IPL
|
1
|
CPSA
|
Do you know of any instances of actual harm or injury?
|
Hypoglycaemic episodes in diabetic patients put on low-carb diets
|
1
|
|
Non-referral to medical practitioners for serious or potentially serious medical conditions
|
2
|
NFR
|
Fracture caused by unqualified orthotists
|
1
|
|
Unqualified people offering counselling services
|
1
|
|
Professional neglect of patients in need
|
1
|
|
Physical, psychological and sexual abuse
|
3
|
ARONAH
|
Professional Standards complaints in QLD
|
1
|
SPBQ
|
Patients exploited by unproven cancer ‘cures’
|
5
|
NFR, CCWA, HSC
|
Misconduct performing transvaginal ultrasounds
|
2
|
ASA
|
Patients seriously financially disadvantaged with life threatening or fatal outcomes esp. cancer treatments
|
2
|
MSC, HSC
|
Seminars/retreats by unqualified practitioners using Cognitive Psychotherapy techniques
|
2
|
IBPA, CPWA
|
Untrained/unqualified retailers offering training
|
1
|
|
Counsellors failing to address safety issues in domestic violence situations
|
1
|
|
Harm caused by untrained arts therapists
|
1
|
ANZATA
|
B17 poisoning
|
1
|
|
False positive or false negative results
|
2
|
MRPBV, AIMS
|
Failure to refer to a specialist/medical practitioner/monopolisation of care
|
2
|
ARONAH
|
False memories have destroyed families and caused irreparable psychological damage
|
2
|
AFMA
|
Financial exploitation/loss
|
1
|
|
Damaging 'counselling' services by exploitative practitioners in a cult-like environment
|
3
|
CPWA
|
Lack of specialised care causing major morbidity or death
|
1
|
ANZCP
|
Infant fatality due to rice milk diet
|
1
|
NFR
|
Cases of paediatric mismanagement of diabetes and cerebral palsy
|
1
|
NFR
|
Patients advised to cease conventional medical treatment
|
3
|
ARONAH, AHA, NHAA
|
Manslaughter by gross criminal negligence (case study provided)
|
1
|
AHA
|
Inquest into death of bowel cancer patient by WA coroner (case study provided)
|
1
|
AHA
|
Prothesis failure
|
1
|
AOPA
|
Financial detriment in excess of $35,000
|
1
|
CPWA
|
Depression, anxiety and suicidal thoughts due to false memory therapy
|
2
|
CPWA, AFMA
|
Unqualified practitioners offering 'cosmetic' homotoxicology
|
1
|
AACMA
|
NSW social worker using position of trust to lure young victims
|
1
|
AASW
|
Social worker in public hospital engaging in sexual relations with rehab patient
|
1
|
AASW
|
Death caused in SA by wrong blood issues following cross-matching
|
1
|
AIMS
|
Unnecessary procedures undertaken as a result of false positives
|
1
|
AIMS
|
Reiki Australia has acted in two states as an expert witness in sexual assault cases
|
1
|
RA
|
Patient harm and death associated with poor practice
|
1
|
ASAPO
|
Burns due to calibration error made by an untrained beauty therapist
|
1
|
CPSA
|
Patient given false negative result by unproven breast screening technique
|
1
|
CCWA
|
Failure to detect underlying mental health condition
|
1
|
HSC
|
What evidence is available on the nature, frequency and severity of risks?
|
Patient feedback/testimony
|
3
|
|
Without professional regulation there is no mechanism to accurately monitor.
|
1
|
|
Anecdotal
|
1
|
|
Websites promoting the use of unscientific diagnostic devices and disproven practices
|
1
|
|
Court cases
|
1
|
|
ATMS complaints committee processes complaints
|
1
|
ATMS
|
Incidents are often under reported
|
8
|
VAHLC, TOCHCC, ANMFSA, PA, ARONAH, RA
|
Indemnity insurance claims
|
3
|
AMT, AA, CMA
|
HCCC/State complaints data
|
4
|
AMT, ARC, SPA, NHAA
|
There are a number of research papers into suggestive therapy techniques
|
2
|
AFMA
|
Overseas data can be extrapolated
|
1
|
|
Government service providers' annual reports
|
1
|
PA
|
Online Perfusion Incident Reporting System
|
1
|
ANZCP
|
No real mechanism to accurately monitor or record risks
|
1
|
AASW
|
Cosmetic Surgery Report to the NSW Minister for Health October 1999
|
1
|
CPSA
|
OHSC data
|
1
|
HSC
|
What factors increase or reduce the risk that individuals will suffer harm as a result of the activities of unregistered health practitioners?
|
Lack of medical management of medical conditions by unregistered practitioners
|
1
|
|
Poor health literacy/ lack of patient knowledge
|
5
|
|
Complexity of the condition/number of options for treatment
|
1
|
|
Not registering practitioners increases risk
|
5
|
ANMFSA, OHPA
|
Excessive workload/under staffing
|
6
|
AASW
|
Lack of training and/or CPD
|
28
|
ATMS, NCC, ESSA, ANZATA, ARC, VAHLC, RAA, AOPA, ASTA, AASW, OHPA, DAA, CPSA, HQCC, CMA, AURA
|
Lack of accountability
|
9
|
ESSA, AMT, AASW, DAA, SASH
|
Non-protection of title
|
10
|
ESSA, AOPA, AASW, CMA
|
Lack of legal structure/recourse
|
9
|
AMT, AASW, AFMA, HCQ, HSC
|
Lack of remedial/complaints process
|
8
|
AASW, CMA, SASH
|
Practice that occurs in situations of crisis
|
1
|
|
No set criteria/framework/scope of practice
|
3
|
SPBQ, VAHLC, ASTA
|
Vulnerable patients e.g. the elderly, juvenile or chronically ill
|
12
|
TOHCC, ACAA, ARONAH, AASW, ACQ, AURA, HCQ
|
No requirement for unregistered practitioners to use therapeutic goods that are on the ARTG register
|
1
|
|
Professional organisations reduce the risk, but don’t eliminate it
|
1
|
|
Remote/isolated practice
|
11
|
VAHLC, AMT, AASW, PACFA, ANZSRS, HCQ
|
Access to certain medications, such as Schedule 1 herbs
|
1
|
ATMS
|
Potential financial gain from vulnerable clients
|
1
|
VAHLC
|
Unsupervised practice
|
7
|
VAHLC, MRBV, ANMFSA, AASW, PACFA
|
No requirement for practitioners to join professional associations
|
9
|
RAA, ANMBSA, AOPA, OAB, HQCC
|
Strong university accreditation programs decrease risk
|
1
|
ESSA
|
No barriers to entry/ease of entry
|
5
|
AMT, TOHCC, ARONAH, NHAA, HQCC
|
Mandatory training grounded in evidence-based studies into memory formation for all mental health providers decreases risk
|
2
|
AFMA
|
Failure to inform medical practitioner about CAM therapy being undertaken
|
1
|
|
Lack of or inadequate peer support
|
2
|
TOHCC, PAFA
|
Inability to prevent unfit people from practising
|
5
|
ASTA, BUPA, AMTA, RA
|
Contracting out of government social services
|
1
|
|
Reduced risk: access to information; community and peer engagement; transparency in reporting, procedural processes and investigation.
|
1
|
PA
|
Requirement to hold a current Certificate of Clinical Practice reduces risk
|
2
|
AA, AIMS
|
Professional or employer codes of conduct reduce risk
|
5
|
DSCWA, DAA, RA, CMA, AURA
|
Membership of professional associations reduces risk
|
7
|
PACFA, DAA, IBPA, NHAA, CHCA, CMA, AURA
|
Appropriate training standards for practitioners and supervisors reduces risk
|
3
|
PACFA, AIMS, ASAPO
|
Informed consent reduces risk
|
1
|
RA
|
A national registry of practitioners would reduce risk
|
1
|
ASAPO
|
Appropriate levels of indemnity insurance decreases risk
|
3
|
CMA, AURA
|
Probity checking decreases risk
|
1
|
HQCC
|
What do you think should be the objectives of government action in this area?
|
National registration
|
16
|
VAHLC, SARRAH, BUPA, QPCS, ANZSRS, ADPA
|
Protection of the public from unqualified practitioners
|
9
|
AHA, ANZSRS, NHAA, AURA
|
Safer practice through more information and training
|
3
|
|
Ensure standards and protect the public
|
20
|
ANZATA, AA, DSCWA, AASW, ANZSRS, RA, HCSCC, HQCC, CMA
|
Title protection
|
6
|
ESSA, SPA, AODA, CMA
|
Set standards of tertiary education
|
1
|
|
Develop a national code of conduct and complaints handling mechanism/body
|
5
|
URN, RAA, SASH
|
Review and assessment to accredit practitioners
|
1
|
|
Protect the public /(esp. vulnerable patients)
|
5
|
SPBQ, TOHCC
|
Controls on what can and cannot be claimed by practitioners
|
2
|
|
Immediate response/deregistration for certain offences
|
1
|
|
A clear well publicised pathway for public complaints
|
16
|
RAA, MRPBV, NIB, AHA, AOPA, STAA, AOB, ADPA, AFMA, RA, AAMT, NTDH
|
A minimalist, low-cost, consistent system to protect public and the professions
|
3
|
LCANZ, NATCOM, HCIA
|
Support national professional bodies/ self-regulation
|
