Abstract
Eleanor M Dawson, Pymble, New South Wales, Australia:
Psychiatrists and their patients require fuller protection from professional regulatory bodies than is currently available. This includes a more effective way of addressing complaints in ways to minimize the risk of injustice to anyone.
I urge the Royal Australian and New Zealand College of Psychiatrists (the College) to become actively involved in educating, advising and monitoring the statutory systems. For example, in New South Wales there are two relevant authorities, the NSW Medical Board (the Board) and the Health Care Complaints Commission (the HCCC). The College awaits the outcome of investigations and disciplinary inquiries by these agencies before concluding any deliberations of its own.
While a complainant dissatisfied with a finding of a Medical Board Professional Standards Committee appears to be able to appeal to the Medical Tribunal under the ambiguous provisions of the Medical Practice Act [1], in practice this is not so. The HCCC remains the only complainant with the standing to appeal [2]. Yet the HCCC has also chosen its original advisers, conducted the investigation, made recommendations to the Board, and decided with the Board whether to make a formal complaint and where and how to prosecute that complaint at an inquiry.
Psychiatrists on the Peer Review Panel of the HCCC advise it during investigation of the complaint. They are then remunerated for reports to the HCCC after review of its file and for appearing as witnesses at any resulting committee or tribunal inquiry [3]. This inquiry may be held in camera by an ad hoc professional standards committee appointed by the Board or in open court by a medical tribunal presided over by a judge.
The reports prepared by the psychiatrists on the Peer Review Panel carry considerable weight, though they may remain legally privileged and inscrutable. This means that possible deficiencies and biases in the peer review opinions may remain unchallenged. Furthermore, the criteria by which psychiatrists are selected to the HCCC peer review panel remain quite obscure, as did until recently the names of the peer review panellists [4].
I urge our College to take the lead when aware of the outcome of the current NSW Parliamentary Committee's Inquiry into Procedures followed during HCCC Investigations and Prosecutions. There is an urgent need for the College to consult with its own membership and to develop clear and fair policies and procedures in the area of professional regulation, particularly in dealing with complaints brought against College Fellows.