LI 1 – Why is there a need to regulate the Medical Profession

Because as medical professionals we have greater knowledge than normal humans, we also have
greater power. The ‘commoners’ trust us to act in their interest and on their behalf. With great
power also comes great responsibility, and this is ensured by regulating the medical profession so
that there is a reduced likelihood of a medical professional exploiting the vulnerability of a patient.
The inherent trust that people have in doctors means that historically they have been able to self
govern and self regulate. However, because doctors deal with the power of life and death the law
does not leave this power to individuals to be decided on a arbitrary basis. Having a regulatory
mechanism at arms length from the individual doctors attempts to address the power imbalance in
the doctor-patient relationship.
Word for word from his lecture.....”Why regulate medical practice?”
• Principles of social justice require legal intervention to enable fair
distribution of resources.
• Protection of a basic human right.
• To provide a mechanism for adequate compensation should
medical misadventure occur.
• To monitor standards of care and to deter poor medical practices.
Traditionally self regulation has been the most common. The public trusts the profession to ensure
a good standards of care.
Self regulation responsibilities include
Education of Doctors
Registration and Deregistration
Dealing with professional misconduct
Deciding how much the fee for service will be called “Pecuniary reimbursement for services.”
Again, straight from the lecture.
Examples of self regulation by doctors
The Australian Medical Association (AMA) – this organisation is seen to represent all doctors and
is widely consulted by government on medical issues.
There are a myriad of individual specialist associations (eg. Royal Australian College of General
Practitioners).
Medical Boards – these are administrative organisations set up under statute. The Queensland
Medical Board comprises 10 members of whom seven are medical practitioners. Their duties
include, but are not limited to, deciding on matters of registration and investigating and
commenting on alleged professional misconduct.
The Health Practitioners Tribunal (HPT) is an administrative/legal body, which hears matters
that have been referred by the Medical Board for hearing in relation to failure to meet professional
standards, professional misconduct and other community instigated complaints. The HPT is
presided over by a District Court judge and is assisted by three assessors (normally two of these are
medical practitioners).

Tort Law: Means ‘wrong’ or ‘injury’. Relates to medical mistakes. In medicine, tort law relates to
infringement of rights such as right to physical integrity and personal liberty.
Tort law aims to 1.Compensate for loss suffered from the wrongdoing. 2.Decide who is liable. 3.
Act as a deterrent to wrongdoing by people or organisations.
Examples are Negligence, battery and wrongful imprisonment.

Criminal Law – The criminal standard is higher than the civil standard
To satisfy criminal negligence it must be shown that “the negligence of the accused went beyond a
mere matter of compensation between subjects and showed such disregard for the life and safety of
others as to amount to a crime against the State and conduct deserving punishment”

Legislation
Commonwealth
The Commonwealth government’s major responsibilities for the
health system include:
» The two main subsidy schemes, Medicare, which subsidises payments for
services provided by doctors, and the Pharmaceutical Benefits Scheme, which
subsidises prescription medicines.
» Shared responsibility for funding for public hospital services through Australian
Health Care Agreements with State and Territory governments.
» Subsidisation of private health insurance.
» Residential aged care.
Some relevant Commonwealth Legislation.
Health Insurance Act 1973 (Cth) which establishes and regulates the Medicare system.
National Health Act 1953 (Cth) which contains amongst other things provisions relating to the
funding of approved nursing homes and the pharmaceutical benefits scheme.
National Health and Medical Research Council Act 1992 (Cth) sets up the NH&MRC detailing the
Council’s functions and obligations. The NH&MRC has among its functions to consider ethical
issues relating to health.

State
State and Territory Governments
State and Territory governments contribute funding for, and
deliver a range of health care services including:
» Management of a shared responsibility for funding public hospitals
» Funding for and management of a range of community health
services
» Ambulance services
» Public Health Programs
» Public Dental Programs
» Public Mental Health Programs
» Health policy research and policy development
» Specialist palliative care, and
» Regulation of various aspects of the health system, including the
licensing and registration of private hospitals, medical practitioners,
and other health professionals.
Some relevant State Legislation
Medical Practitioners Registration Act 2001 (Qld). Established the Medical Board
Medical Board (Administration) Act 2006 (Qld) Helps with admin for the board.
Health Practitioners (Professional Standards) Act 1999 (Qld) Upholds standards of practice and
sets up ways to deal with complaints, investigation and discipline.
Health Quality and Complaints Commission Act 2006 (Qld)
(1) Monitoring, reviewing and reporting on the quality of health services, and
(2) Managing complaints regarding health services.