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Groups voice AHPRA concerns

The problem-prone national registration system has left a number of nurses, and other health professionals, frustrated, unable to work and financially disadvantaged.

The registration of nurse practitioners has been blocked by AHPRA since the changeover to that national scheme in July last year.

Midwives have been refused endorsement because they couldn’t demonstrate five years of postgraduate study. The standard states 3 years.

Individual nurses are waiting months to receive their practicing certificate – something casual nurses need to get work.

The problem-prone national registration system has left a number of nurses, and other health professionals, frustrated, unable to work and financially disadvantaged.

As a result, health groups and individuals have jumped at the chance to voice their concerns and criticisms of the agency ahead of the Senate inquiry.

Many submissions made to the inquiry have been scathing.

Australian College of Nurse Practitioners president Helen Grosby said applications have sat for more than eight months at the state branches of AHPRA.

She also said new guidelines for registering were not finalised until March, leaving nurse practitioners frustrated and unable to work.

“Nurses waiting for their applications to be processed so that they could gain endorsement and commence work as a NP were held up due to fact that no guidelines had been made available to the branches detailing how to process the applications. This had financial and professional ramifications for not only the NPs, but the Australian community who was not able to benefit from the timely care and reduced wait list for specialist services that these NPs could have provided,” Grosby wrote in the submission.

She said the ACNP had been part of the consultation process in the creation of the Guidelines for endorsement as a nurse practitioner for over a year before the changeover to national registration was to commence in 1 July 2010. This process was not finalised until March this year.

“This has resulted in increasing frustration with regards to the lack of information being provided on the progress of applications. The lengthy delay has taken a heavy professional and personal toll on the NPs who have had to wait extended periods for the applications to be processed as they were unable to practice and function at the level they were qualified and experienced to perform.
The Australian College of Midwives, which represents more than representing 5400 members, wrote that moving over to the national scheme has been a “frustrating and arduous process”.

Currently there are 30 midwives, nationally, who have the eligibility endorsement to access MBS and PBS on their registration. For many this process has been challenging, said Tracy Martin, ACM national president.

“Among the issues highlighted was the deviation from the written standard when midwives applications are processed. Midwives were refused the endorsement because they could not demonstrate five years postgraduate experience, but the standard states three years.”

Worryingly, problems with the new national registration system will persist for another two to three years in part due to its chronic underfunding, the head of the Australian Medical Council said.

In its submission, CEO Ian Frank said the government underestimated the enormity of shifting from state-based registration to a unified national.

He said not enough funding was allocated and problems have been worsened because the government had “stepped away” from funding registration and accreditation by expecting the professions to fund it on a user-pays principle.

He came to the defence of AHPRA, saying the agency was doing a good job under difficult circumstances, “being forced to interpret and implement complex new legislation immediately after losing senior staff with expertise in this area”.

He said a longer period of consultation would have allowed AHPRA to anticipate many of the problems, and that lack of consultation was an ongoing problem.

Looking beyond such issues of delays, the Victorian Association of Maternal and Child Health Nurses said the most disappointing matter in relation to registration is the loss of recognition of maternal and child health qualification and registration of that qualification. Previously maternal and child health nurses were registered with the Nurses Board of Victoria and the former Victorian Nursing Council. More recently, Maternal and Child Health qualification was noted as an additional qualification with registration.

This has not been transferred to the new register.

The association wants the inquiry to recognise the implications this has for employment and practice as a maternal and child health nurse in Victoria. “Nurses without the required qualifications to be a maternal and child health nurse in Victoria cannot be employed in the Victorian Maternal and Child Health Service,” said Joanne Fittock, association president.

They are requesting that AHPRA notes their qualification on the register with Victoria in brackets, for example Maternal and Child Health Nurse (Victoria) - in the qualifications section of registration details.

From an individual’s perspective, James Hill has many concerns.

“I returned my application to renew my registration in December 2010 and the cost was deducted from my account. I heard nothing from AHPRA until they sent an email reminding me that my next renewal was due on the 31 May 2011. This is more than two months in advance,” Hill wrote in his submission.

“It is over three months since I paid for my previous renewal and have not received any receipt or more importantly a practicing certificate

“I work casually and need a practicing certificate for employers and places that I am sent to. It now means that any employer has to check on AHPRA’s website. I have been nursing for more than 40 years in a number of countries and never met such appalling service. This organisation is grossly incompetent and they can audit my performance but who audits their performance?”

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