Health Practitioner Regulation National Law Act 2009

The Act applies to every registered health practitioner and student in Queensland, every employer of a registered health practitioner, every education provider of approved programs of study, every applicant for registration in Queensland, and every member of the public who interacts with the registration or notifications regime. National Boards include the Medical Board of Australia, the Nursing and Midwifery Board of Australia, the Dental Board, the Pharmacy Board, the Optometry Board, the Physiotherapy Board, the Psychology Board, the Chiropractic Board, the Osteopathy Board, the Podiatry Board, the Chinese Medicine Board, the Aboriginal and Torres Strait Islander Health Practice Board, the Medical Radiation Practice Board, the Occupational Therapy Board and the Paramedicine Board (established through sections 306 to 309 of the Queensland Act's transitional provisions, with the Paramedicine Board taken to be a National Board for stated matters under section 309).

QCAT acts as the responsible tribunal for serious matters and for review under section 9. The Health Ombudsman acts as the front door for complaints under the Health Ombudsman Act 2013, and refers matters to the National Agency under sections 148 to 151 of the National Law (as modified for Queensland).

Registered practitioners have multiple ongoing obligations. They must comply with continuing professional development requirements set by their National Board (section 128) and maintain professional indemnity insurance arrangements (section 129). They must notify the National Board of certain events (section 130) and notify changes of principal place of practice, address or name (section 131). They must respond to a Board's request for practice information (section 132). They must not advertise their service in ways that contravene section 133 (advertising). They must produce evidence of identity (section 134) and consent to a criminal history check (section 135). They must not direct or incite unprofessional conduct or professional misconduct (section 136). Surrender of registration is regulated in section 137.

Mandatory notifications obligations are central. Section 141 imposes a mandatory notification obligation on health practitioners (other than treating practitioners) where another practitioner has engaged in notifiable conduct as defined in section 140. Section 141A imposes a narrower mandatory notification obligation on treating practitioners specifically for sexual misconduct. Employers have a section 142 mandatory notification duty. Education providers have a section 143 duty. A new section 143A (added by section 28 of this Act for Queensland) extends mandatory notifications to the Queensland Health Ombudsman.

Voluntary notifications are governed by sections 144 and 145. Notifications are made under section 146.

Restricted titles are protected by section 113 (use of protected titles), section 114 (use of "acupuncturist"), section 115 (use of specialist titles), section 116 (claims by persons as to registration as health practitioner), section 117 (claims as to registration in particular profession or division), section 118 (claims as to specialist registration) and section 119 (claims about type of registration or registration in recognised specialty). Restricted acts are addressed by section 121 (restricted dental acts), section 122 (restriction on prescription of optical appliances) and section 123 (restriction on spinal manipulation).

National Boards may grant or refuse registration (Part 7 of the National Law), grant or refuse endorsements (sections 99 to 106), change or remove conditions on application (section 125), change conditions on the Board's initiative (section 126), and remove or revoke conditions or undertakings (section 127). Boards may issue a certificate of registration (section 124).

National Boards may, on receiving a notification, decide to take no further action (section 151), conduct a preliminary assessment (section 150), require information (section 150A), inspect documents (section 150B), refer the matter to other entities (section 150C), or refer the matter to the National Agency. The Boards may require a health assessment (section 169) or performance assessment (section 170) of a practitioner. The Board may take a wide range of actions under section 178 (caution, condition, suspension, referral). The responsible tribunal (QCAT) may impose serious disciplinary sanctions including suspension and cancellation of registration.

The National Agency must establish health panels (section 181) and performance and professional standards panels (section 182). The Board must give notice of decisions to the practitioner and notifier (sections 180 and 192). The notifier may make submissions to the panel (section 187). Decisions of panels are subject to referral to the responsible tribunal or National Board (section 190).

The Police Commissioner may give criminal history information to the National Agency (section 8 of the local application provisions). The Minister may make regulations under section 9A.

The protection of restricted titles and acts is enforced by the offences in sections 113, 116, 117, 118, 121, 122 and 123 of the National Law. Use of a protected title without registration in the corresponding profession is a strict-liability offence. Restricted dental acts performed by an unauthorised person, restricted prescription of optical appliances and restricted spinal manipulation by unqualified persons are similarly offence-creating. Penalties under the National Law are stated in penalty units, with the Queensland penalty unit value applying.

The National Agency, Boards and Health Ombudsman together exercise the disciplinary architecture. The most serious sanctions (suspension, cancellation, condition imposition or imposed undertaking with disqualification consequences) are imposed by QCAT as the responsible tribunal. Section 196A and sections 222, 223 and 227 deal with prohibition orders. Section 326 of the local application provisions applies sections 196A, 222, 223 and 227 to particular prohibition orders made before the commencement of relevant amendments.

Registration applications are decided under sections 80 to 86. Applicants may make submissions about a proposed refusal or imposition of conditions (sections 84 and 101). Endorsements are decided under sections 99 to 106. Renewals must be applied for under section 107, with continued registration in force under section 108. Annual statements are filed under section 109. Boards may seek information before deciding renewal under section 110. Decisions on renewal are made under section 112.

Notifications follow a defined pipeline: receipt and notice (section 152); ability to deal with multiple notifications about the same person together (section 153) and to deal collaboratively across Boards (section 154); preliminary assessment (section 150); decision to take no further action, refer to investigation, refer to panel or refer to the responsible tribunal. Investigations are governed by sections 160 to 161. Health assessments are required under section 169. Performance assessments are required under section 170. The Board's decision after assessment is under section 177; possible actions are listed in section 178.

Panels (health panel and performance and professional standards panel) sit under sections 181 and 182, with appointment from a list of approved persons (section 183). Notifier submissions are under section 187. Referral to the tribunal or National Board is under section 190. Panel decisions are under section 191 and notice under section 192.

Review by QCAT as the responsible tribunal is available under section 9 of the local application provisions. The Federal Court is the bankruptcy and judicial review forum where the Board exercises related powers; for example Broadbent v Medical Board of Australia [2023] FCAFC 186 records the Board's pursuit of a sequestration order based on unpaid costs orders in disciplinary proceedings.

The Act interacts most closely with the Health Ombudsman Act 2013 of Queensland, which is the front door for health complaints in Queensland. Sections 7A to 7C and 9 of the local application provisions accommodate the Queensland co-regulatory architecture. Section 148 (modified by Part 4) governs referral of notifications between the National Agency and the Health Ombudsman.

The Therapeutic Goods Act 1989 (Cth) is referenced through the definition of "scheduled medicine" (substance included in a Schedule to the current Poisons Standard). The Acquisition of Land Act 1967 and other Queensland Acts are excluded by section 7 to the extent they would otherwise overlap. The Queensland Civil and Administrative Tribunal Act 2009 governs QCAT's procedures as responsible tribunal. The Federal Court of Australia Act 1976 (Cth) provides bankruptcy and judicial review pathways where relevant.

The mandatory notification obligations in section 141 trip practitioners who learn of notifiable conduct by a colleague during the course of practice. Treating practitioners are subject to a narrower obligation under section 141A, which is limited to sexual misconduct, but this carve-out is not a carve-out for non-treating colleagues. Misreading the scope of section 141A versus section 141 is a common compliance trap.

Restricted titles in section 113 are strict-liability offences. Use of "doctor", "nurse", "dental practitioner", "pharmacist" or any other protected title without current registration in the corresponding division is offence-creating. Misuse can occur through a website that is not promptly updated after a registration lapse.

The Queensland co-regulatory front door is the Health Ombudsman, not Ahpra. A complaint sent to Ahpra directly may be referred back to the Health Ombudsman for triage.

QCAT is the responsible tribunal in Queensland (section 6) for serious matters. Sanctions imposed by QCAT (suspension, cancellation) are reviewable to the Court of Appeal, but the QCAT proceeding itself is the merits-review forum. Internal review by the Board may be available for some decisions; section 9 of the local application provisions governs review of decisions by QCAT.

The advertising restrictions in section 133 of the National Law have been the subject of guideline disputes; Callan v Medical Board of Australia [2024] NSWSC 336 records judicial review of cosmetic surgery and advertising guidelines issued by the Medical Board of Australia.

A medical practitioner who learns that a hospital colleague has practised while intoxicated must consider whether section 140 notifiable conduct applies and, if so, whether the section 141 mandatory notification obligation is engaged. Failure to notify exposes the observer to disciplinary action.

A nurse who advertises specialist nurse practitioner services without holding the corresponding endorsement under section 95 contravenes the protected-title regime. The Board may take action under section 178, including a caution, conditions on registration, or referral to QCAT.

An employer of a registered medical practitioner who becomes aware of patient injury caused by intoxicated practice must notify under section 142. If the employer is also a hospital with a Health Ombudsman complaint pathway, the matter may be triaged by the Health Ombudsman first.

A medical graduate who is not eligible for general registration under section 52 of the National Law, and who applies under another registration type, is subject to the Board's discretion as analysed in Ibrahim v Medical Board of Australia [2015] NSWCA 207. The Court of Appeal of New South Wales there identified that the National Law is adopted under the New South Wales Adoption Act with modifications, applying as the law of New South Wales.

A medical practitioner whose registration is suspended on serious grounds may face additional consequences including bankruptcy if costs orders accumulate; Broadbent v Medical Board of Australia [2023] FCAFC 186 records the Board's pursuit of a $79,468.73 sequestration order arising from unpaid disciplinary costs.

The Queensland-specific provisions in Part 3 and the modifications in Part 4 align the National Law with the Health Ombudsman Act 2013. Sections 148 to 151 of the National Law (as modified) govern preliminary assessment of notifications. Section 150A confers a power to require information; section 150B confers an inspection power; section 150C governs referral to other entities. Where a matter is referred to the National Agency by the Health Ombudsman, sections 148 to 154 of the National Law (as modified) apply. The Queensland-specific division 12 referral to the Health Ombudsman or responsible tribunal is governed by section 50 (and the National Law sections 193 to 195 as replaced by section 50 of this Act).