Australia's health system exposed on the issue of trust

THERE are more than 650,000 health practitioners in Australia registered with the Australian Health Practitioner Regulation Agency across 14 professions.

Individual practitioners pay annual registration fees set by their profession’s national boards, which in 2016/17 range from $110 for physiotherapists, $150 for midwives, $300 for optometrists, $724 for general practitioners and specialists and $378 for podiatrists.

Patients are advised to go to the AHPRA website to check if their health practitioners are registered and have the qualifications to specialise in various fields. The website also shows if there are conditions placed over a health practitioner’s registration following complaints and investigations.

But the AHPRA website will not show you a health practitioner’s history. There is no mention of any legal action, no whisper of civil settlements, no recording of previous suspensions, in Australia or overseas, which is where the foundation of our health system has been exposed by the pelvic mesh catastrophe.

It’s a system that relies on the trust relationship between health practitioner and patient, and the trust patients have when they walk through the door of a surgery or hospital – that if there are risks, the patient will be told.

That hasn’t happened for too many women when it comes to pelvic mesh device surgery for incontinence and prolapse repair, primarily after childbirth.

They have trusted doctors to warn them of the risks; they have trusted that mesh devices cleared for use in Australia have passed rigorous safety and efficacy standards, and they have trusted that when things go wrong, regulators respond.

The nib submission to the Senate inquiry into pelvic mesh devices exposes the reality of women’s experiences when they have had surgery – one in two have had to be readmitted to hospital with complications.

Although the sample figure is small – 138 women, with 60 readmitted to hospital – it is actual data, as opposed to statements made by regulators, and doctors’ associations and device manufacturers, that mesh device complications are low, based on incomplete baseline data.

nib chief executive Mark Fitzgibbon said significant change in health often follows controversy. The Senate inquiry is at least letting some light on the subject.

Issue: 38,555.