VICTORIA, AUSTRALIA
WHISTLEBLOWER’S LEGISLATION – THE IMPACT ON DOCTORS
This article aims to make the profession aware of the Whistleblowers Protection Act 2001 (WPA) and to consider how it might impact medical practitioners.
On Jan. 1, 2002, the Whistleblowers Protection Act 2001 (WPA) came into operation. The WPA provides a legislative framework for individuals who wish to notify the relevant authorities about improper conduct engaged in by public bodies and their employees.
The objectives of the legislation are to:
promote a culture in which complainants feel safe to make a disclosure;
protect people who disclose information from recrimination or other adverse consequences;
provide a framework for investigating disclosed matters; and
ensure that investigated matters are properly dealt with.
The WPA recognizes that improper conduct by employees within the public service should not be tolerated, neither should actions which involve reprisals against those who come forward to disclose such conduct. The WPA defines improper conduct as:
corrupt conduct;
a substantial mismanagement of public resources;
conduct involving substantial risk to public health or safety; or
conduct involving substantial risk to environment.
The WPA requires that the improper conduct would, if proved, be a criminal offense or constitute reasonable grounds for dismissal.
HOW MIGHT THE WPA IMPACT MEDICAL PRACTITIONERS?
The WPA might impact on medical practitioners in the following circumstances:
Any person has a right to make a disclosure about improper conduct engaged in by a public body or its employees, including staff in public and privately-operated hospitals.
Any person can make a disclosure about improper conduct engaged in by a doctor in a public hospital.
Any person can make a disclosure against a doctor in a privately-operated hospital that provides health services to public hospital patients, but only in respect of improper conduct that relates to the health services which the practitioner provides to public hospital patients.
According to Schedule 4 of the Health Services Act 1988, there are currently two privately-operated hospitals in Victoria – the new Latrobe Regional Hospital and the new Mildura Base Hospital. In the case of a hospital, the Ombudsman’s view is that common medical negligence is not a matter to be dealt with under the WPA. Rather, the WPA may apply where staff have sought to cover up medical negligence.
Another example may be the theft of drugs by staff, who then administer the drugs to themselves or others. In terms of hospital management, the WPA would apply to the mismanagement of major projects at the expense of the Victorian taxpayer, the theft of hospital funds, the lack of probity in the awarding of contracts and the systemic provision of jobs to friends and family.
WHEN DOES THE COMPLAINANT GET PROTECTION?
The complainant gets protection when the Ombudsman or the Protected Disclosure Coordinator (PDC) of the relevant public body, determines that the complainant’s disclosure amounts to a ‘protected disclosure.’ A disclosure amounts to a protected disclosure when the Ombudsman or PDC determines that the complainant:
has alleged that improper conduct has been, is being or will be engaged in by a public body/officer; and
has demonstrated that s/he has reasonable grounds for this belief.
HOW IS A DISCLOSURE MADE?
Disclosures against a public body are made by contacting either the Ombudsman or the PDC at the relevant public body. Each public body is required to establish written procedures for handling disclosures made under the WPA, including the appointment of a PDC. If a disclosure is about a Member of Parliament (MP), the disclosure must be made to either the speaker of the Legislative Assembly or the President of the Legislative Council depending on which house the MP belongs.
A disclosure can be made either orally or in writing and may be made anonymously. Disclosures should include the specific allegations, a statement in support of the allegations and any documentation that supports the allegations.
Public bodies are required to receive and assess disclosures in accordance with the WPA. They are also required to investigate disclosed matters when referred from the Ombudsman and take appropriate action when improper conduct has been found to have occurred. Finally, they are required to provide welfare management to complainants, who have made protected disclosures.
WHAT DOES THE PROTECTION INCLUDE?
When the Ombudsman or the PDC determines that a complainant has made a protected disclosure, the complainant receives the following protection:
there is immunity from any civil or criminal liability or administrative process, including disciplinary action, for making a protected disclosure;
there is immunity from the confidentiality provision of any agreement or Act, including the Constitution Act 1975, regarding the content of a protected disclosure;
criminal charges can be brought against any person, who takes detrimental action against the complainant, where this action is taken in reprisal for having made a protected disclosure under the WPA (penalty: two years imprisonment and/or $24,000 fine); and
criminal charges can be brought against any person who reveals the complainant’s identity and/or the content of the disclosure, otherwise than in accordance with that person’s statutory functions under the WPA (penalty: five months imprisonment and/or $6,000 fine).
ANY QUESTIONS?
Contact either the PDC at your hospital or the Ombudsman’s office on: Tel: (03) 9613 6222, Fax: (03) 9614 0246; e-mail: [email protected]
Reprinted from the Vol. 3 issue of Medical Practitioners Board of Victoria Bulletin.
ALBERTA, CANADA
COLLEGE LAUNCHES ITS LABORATORY QUALITY ENHANCEMENT PROGRAM (ALQEP)
Since 1965, the College has monitored the performance of diagnostic medical laboratories through its Laboratory Proficiency Testing Program (LPTP).
This includes an annual review of over 12,500 results in five disciplines including chemistry, cytopathology, hematology, microbiology and transfusion medicine for over 150 laboratories.
The current name has been associated with the program since its inception in 1966 when the program’s singular role was in proficiency testing performance assessment.
In keeping with our strategic planning process the LPTP Committee of the College proposed a program name change to encompass the broader scope and mandate of the program including:
enhancing the scope of external quality assessment (EQA) monitoring;
enhancing educational support role through the provision of enhanced resource and reference materials and the coordination of quality assurance forums and activities; and
promoting standardization of laboratory practice.
The new name is intended to reflect and promote our strategic planning initiatives and image as a laboratory quality management reference body.
Complete program information is available on the College’s website at www.cpsa.ab.ca.
CENTENNIAL CELEBRATIONS
A Centennial Celebration Steering Committee has begun planning for the medical profession’s 100th birthday in Alberta. Celebrations will coincide with the province’s centennial in 2005. Spearheaded by the College and the AMA, the goals of the planning committee are to raise awareness of the profession’s 100th birthday and to facilitate ideas on how Alberta physicians and other groups can celebrate medicine’s past, present and future. To date, the Committee has designed a centennial logo, launched a centennial website and sent a letter to all physicians and stakeholder groups inviting them to get involved. Share the pride in our medical profession by helping us highlight physicians’ contributions to health care, the health system and the economic growth and prosperity of our province. If you have suggestions for projects or ideas about how to celebrate 100 years of medicine in Alberta, contact Nancy Brenneman at (780) 482-0312 or visit www.medicine100.ab.ca.
PRESCRIBING ONLINE
Internet pharmacies and cross-border prescribing are important topic areas for physicians and pharmacists alike.
For Physicians:
According to College policy, prescribing medications based only on verbal information, fax, telephone or electronic means, is not an acceptable standard of care. An appropriate history and physical must be done first.
The only exception to this policy is when physicians are fulfilling their responsibility as a member of an on-call group.
As pertains to cross-border prescribing, therefore, signing or countersigning prescriptions written for U.S. patients by U.S. physicians may be viewed as unprofessional conduct.
For Pharmacists:
Pharmacists are responsible for ensuring that a prescription is authentic. Therefore, they will not accept prescriptions sent by email, as there are insufficient security measures in place to ensure the prescription is valid.
Pharmacists are also unable to accept prescriptions printed by a computer or sent by fax unless the physician has signed the order. Physicians using electronic medical records and/or the Pharmaceutical Information Network (PIN) will still be required to create a signed prescription in order for a pharmacist to fill the request.
Cross-border prescribing continues to cause concern in the larger medical community as well.
The College supports Health Canada’s Food and Drug Regulations that state that prescription drugs may only be sold at retail if prescribed by a practitioner licensed to practice in Canada.
Reprinted from the online version of issue number 107 of the Messenger, found on the College of Physicians and Surgeons of Alberta website.
NOVA SCOTIA, CANADA
EMERGENCY DEPARTMENT REFILLS OF CONTROLLED SUBSTANCES
The misuse, theft and diversion of controlled substances have recently made headlines in Nova Scotia. Emergency department staff have been concerned for some time with this problem and have expressed their concerns to the College. Problems arise when patients present at ER departments demanding refills for controlled substances that were originally prescribed by physicians who are unavailable. In such cases, it is very difficult for ER physicians to know what is, or is not, a legitimate request.
ER physicians may not ordinarily provide such refills. In cases where they do provide refills, they typically prescribe just enough medication to suffice until the patient can see the physician who wrote the original prescription.
The College publication Guidelines for the Use of Controlled Substances in the Treatment of Pain recommends that physicians have a written agreement with patients whom they determine to be at high risk for medication abuse or who have a history of substance abuse. The guidelines provide examples of such contracts or agreements, which can be tremendously useful for both the physician and the patient. It may be valuable to have such written agreements with all patients so that if an urgent refill is required in an emergency department, the agreement can be presented to emergency department staff.
Alternately, physicians planning to be unavailable during weekends or vacations should make advance arrangements for a colleague to be available to their patients in case urgent refills are required. One important concept in all pain management is that only one physician be responsible for the opioid therapy of any one patient. This point cannot be overemphasized.
Physicians are reminded of the significant and ongoing responsibility when initiating long-term opioid therapy for patients. The benefits to patients in need are tremendous, but laxity in follow-up and loose control by multiple prescribers can have terrible social consequences in terms of drug diversion, crime, substance abuse and public health.
Reprinted from the College of Physicians & Surgeons of Manitoba website.
SASKATCHEWAN, CANADA
CONTINUING MEDICAL EDUCATION REQUIREMENT
The Council of the College has established a Revalidation Committee. The task of this committee is to make recommendations to the Council respecting requirements for physicians to demonstrate ongoing education and/or competence as a condition of practice in Saskatchewan.
The Committee consists of Dr. David Ahmed of Regina, Dr. Suresh Kassett of Herbert, Dr. Prakesh Patel of Regina, Dr. Karen Shaw, Deputy Registrar and Mr. Bryan Salte, Associate Registrar.
The Committee is considering whether it should recommend to the Council that physicians be required to meet the requirements of the Maintenance of Competence Program (MOCOMP) (for physicians with specialist credentials) or Maintenance of Proficiency program (MAIN-PRO) (for physicians with family physician credentials). It appears that both the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada are prepared to enroll physicians who are not members of their Colleges in these programs. There would be some cost to physicians who are not members of either College to enroll in the MAINPRO or MOCOMP programs.
Most health professions in Saskatchewan have ongoing maintenance of competence requirements in order to remain in good standing with their regulatory body. It seems likely that in the near future there will be ongoing maintenance of competence requirements for physicians in other provinces of Canada.
Reprinted from the December 2003 edition of College Newsletter, on the College of Physicians and Surgeons of Saskatchewan website.
DUBLIN, IRELAND
IAMRA TO SPONSOR THE 6TH INTERNATIONAL CONFERENCE ON MEDICAL REGULATION
The International Association of Medical Regulatory Authorities (IAMRA) offers state medical boards an invaluable opportunity to build bridges in the international arena. The organization provides a structure to learn the terminology and regulatory structures of other nations. A little less than two years ago, in June 2002, IAMRA was launched with eight founding members. Today, the organization boasts 52 members from 24 countries.
INTERNATIONAL CONFERENCE IN APRIL 2004
An outstanding opportunity to meet fellow medical regulators from around the world will soon be here. IAMRA is sponsoring the 6th International Conference on Medical Regulation in Dublin, Ireland, April 21–24, 2004.
An ambitious program for the conference is in the process of being finalized by the Medical Council of Ireland, and will include reports by IAMRA’s Working Group on the International Exchange of Information on Physicians (IEIP) and the Working Group on Medical Passports, with sessions incorporated in the program to explore these issues in more depth, generate discussion and foster new ideas and collaboration. IAMRA’s second Members General Meeting will take place on the second day of the conference and will include the election of a new Management Committee.
The proceedings also will incorporate a report on developing a collaborative plan of work, with the objective of publishing a paper or a book that will serve as the basis for submitting a proposal to be a non-governmental organization in official relations with the World Health Organization (WHO).
Registration and other detailed information about the conference can be found on IAMRA’s website at www.iamra.com. You also may register for the conference online and view a draft program by accessing the Medical Council of Ireland website.
LET US HEAR FROM YOU
Would you like for information from your board to be considered for publication in the Journal? If so, e-mail articles and news releases to Edward Pittman at [email protected] or send via fax to (817) 868-4098.
