Under legislation passed this month, health professionals found to have engaged in sexual misconduct by a tribunal will be permanently listed on a public register.
AHPRA says the bill will increase transparency for the public and better protect people who make complaints about health practitioners. It will also ban non-disclosure agreements that stop patients from making complaints.
However, while nearly everyone agrees sexual misconduct must be taken seriously, some are concerned that the broadly worded legislation could have tragic unintended consequences.
Among those raising concerns is David Gardner, a lawyer and former AHPRA investigator who now runs compliance training for health professionals.
“I think it’s an extremely problematic position to take because at this point we don’t quite know how they’re going to interpret sexual misconduct,” Mr Gardner told Healthed.
“If they take the broad interpretation, which I suspect that they will, it is basically that any sort of sexualised contact or relationship with a patient is sexual misconduct, and we’re going to give you the scarlet letter for it,” he says.
“It’s concerning to me that there would be no differentiation between a doctor who has sexually assaulted or raped a patient, and someone who has breached professional boundaries, but entered into a relationship with a patient that is consensual.”
“They are two very different things and the difference in risk is significant,” Mr Gardner adds.
“Most of the practitioners who have entered into relationships with patients have often done so in very specific circumstances, and then have undergone bucket loads of education, and are probably the practitioners I would say that are at the lowest risk of ever doing that again,” he says. “I don’t see why we should brand them for the rest of their professional life with the same brand that we might apply to a criminal offender who has engaged in non-consensual sexualised conduct.”
“There is such scope or such discretion that’s given to the Board in that new bill that’s been passed. I do have a lot of concern around it.”
He also worries that the average person won’t look further if the register simply says someone has engaged in sexual misconduct with a link to the tribunal case: “Most people aren’t going to click through, read all the details and go, ‘okay, that’s not as bad as I thought, I still feel safe.’ They’re going to see that and think, I don’t want to see that person.”
Professor Louise Stone, a GP and researcher who is the lead editor of a forthcoming book on sexual harassment in medicine which will be published by Cambridge University Press, also has mixed feelings.
“Who makes the decision that sexual misconduct is ‘proven’ and ‘severe’ enough to be placed on the public record?” she recently asked, stating that the courts are one thing, but the Board or tribunal is another entirely.
“Should we, if we are removing a doctor’s career, at least meet the criteria of ‘beyond reasonable doubt’ rather than ‘on the balance of probabilities’?” Professor Stone continued.
The legislation states that the requirement to record the practitioner’s name in a public register applies if a National Board is satisfied that a “responsible tribunal” decided the practitioner engaged in professional misconduct which included sexual misconduct.
While a national poll showed that more than half of GPs (56%) support the decision, a significant minority (44%) oppose it, with many citing serious concerns. Over 1300 GPs have completed the Healthed survey so far.
GPs who view the amendments favourably noted potential benefits for:
However, around 20% of those who support the idea in principle suggested caveats that are not in the actual legislation, such as making it conditional based on the severity of the case. For example, only for those with repeat offences or multiple victims—but no such nuances are in the bill. Others said there should be a time limit, when in fact, AHPRA says the register will be permanent.
GPs who do not support the amendments expressed concerns including:
Comments from GPs with mixed feelings
“I am a bit divided… I feel disgusted that a doctor is unable to control their sexual needs in the workplace, but I am not in favour of public shaming because of the effect on the practitioner’s family… They should be struck off and leave it at that.”
“I do believe that there is variation in cases AND I believe that cases should be dealt with IN court prior to publicly shaming practitioners.”
“It depends on how the practitioner has been proven guilty.”
“Patient safety is paramount, of course, but I am concerned about suicide risks.”
“It should be on a case-by-case basis. If sexual misconduct was of a limited nature with, say, one patient, it should not be dealt with in the same way as sexual misconduct of a predatory nature against multiple patients over many years.”
Comments from GPs in favour
“AHPRA is too soft on doctors who have been proven guilty of sexual misconduct.”
“Sexual misconduct violates the ‘Prime Directive’ of medical practice, and it appears that in the past guilty parties have managed to repeat offend in different jurisdictions. The principal caveat on this is that there is no doubt of guilt.”
“Public has the right to know if their GP has a history of sexual misconduct.”
“Transparency is essential for maintaining public trust in the healthcare system. Patients have a right to be informed about practitioners who have been found guilty of serious misconduct, especially when it involves breaches of safety and ethics. Publicly disclosing disciplinary history helps protect patients, reinforces accountability, and upholds the standards of the profession.”
Comments from GPs against the decision
“AHPRA action is not appropriate. AHPRA is not a court of law. The Federal Register of Sexual Offenders is not public, why would the MED register be PUBLICLY showing a conviction for sexual misconduct? Such publication is likely to destroy one’s career forever.”
“AHPRA already holds too much power over individuals. I would support the concept, but don’t trust any government agency to use it fairly or as described.”
“AHPRA can be biased and make a mistake in their judgment. If it is proven by a court of law, then it is acceptable.”
“AHPRA needs to disqualify them, not make a spectacle of them – the doctors and their families will have had enough psychological trauma from the courts and the journalist. Publishing is not going to help their victims.”
“Although committing a sexual misconduct is a grave offense, to publicly publish the disciplinary history of practitioners will serve no purpose… This will cause long-term mental health problems such as self-guilt, depression and isolation.”
“If APHRA hasn’t thought it was serious enough to suspend the practitioner, why would they publish these details?? If they have concerns, they should be acting, not being malicious at the keyboard.”
“The practitioner may have changed after disciplinary action, but by making this public, it is nearly impossible to return to practice.”
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