What can you do if you work with unsafe, unregistered health workers?

I get asked this question frequently.  We all know that registered and enrolled nurses and midwives can be reported to AHPRA and steps to limit or deny them the right to practice can be taken if they are shown to lack skills or conduct demanded by the profession.  Since the National Law was passed the titles of registered nurse, enrolled nurse and midwife have been protected and it is a crime to claim to belong to the profession if you are not registered.

Colleagues have told me about situations where they have identified unregulated unsafe, incompetent or inappropriate staff and having reported them to the employer they see no action taken.  This has been a common situation in health service provision for a long time.  Unregulated, that is not registered, health workers in many fields do not have either standards, codes of practice and behaviour or systems for investigation unless they come to the state health department complaints units notice.

The matter has been raised by professional, community and health departments for many years.  After a number of surveys and a staged approach to developing a national system the Final Report: A National Code of Conduct for healthcare workers was prepared by the Victorian Department of Health, on behalf of the Australian Health Ministers’ Advisory Council in 2015.

It had been decided, after extensive research that the currently unregulated health workers would not be registered but a national Code of Conduct would apply a consistent code-regulation regime for all unregistered healthcare workers.

New South Wales, South Australia and since 2014, Queensland have in place a statutory system that provides for investigation, hearings and prohibitions to be made against unsatisfactory health workers who have been reported.  Prohibitions in one state did not prevent the worker moving to another and continuing to work.  This new system would have effect in every state and territory and there would be a national website naming those who were “prohibited” workers.  When the site is active (it was planned for 2017) employers will need to check against it for job applicants.

What is in place, is the Code of Conduct for healthcare workers and this provides standards that a worker can be judged against.  Each state will implement a complaint and investigation system that is similar to those currently in NSW, SA and Qld.  You can see Queensland’s publication of the code at: https://www.health.qld.gov.au/__data/assets/pdf_file/0014/444101/national-code-conduct-health-workers.pdf

The Health Ombudsman in Queensland can issue an interim prohibition order if an unregistered health practitioner’s health, conduct or performance means they pose a serious risk to people, and immediate action is necessary to protect public health and safety.  As each state enacts their own systems there will be similar approaches.

Two examples from Queensland: 15 May 2018, Mr Craig Vervaart, Assistant in nursing; The practitioner is prohibited from providing any health service, paid or otherwise, in a clinical or non-clinical capacity.  22 March 2018, Mr Simon Brennan, Personal carer; The practitioner is prohibited from providing any health service, paid or otherwise, in a clinical or non-clinical capacity.

The National Code is there to provide a standard you can use to objectively assess a worker.  Each state has a complaints system and reporters are protected from any liability for making a report in good faith.  Investigations and prohibition orders can arise from reports.   Should a person who has a prohibition order made against them continue to work anywhere they can be found criminally liable.

There are some fabulous webinar recordings by Pam Savage regarding Nurses and the Law on the Nursing CPD Institute. The  Nurses for Nurses Network provides good information and CPD  on an array of nursing topics in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember the Nurses for Nurses Network was created by Australian Nurses for Nurses! www.ncpdi.com.au