Health Services (Conciliation and Review) Regulations 2010

The regulations operate through five main regulatory concepts: prescribed offences, prescribed interstate orders, prescribed time and providers for s 75, a prescribed form for complaints returns, and a prescribed code of conduct for certain health care workers. Each concept is implemented as a discrete regulatory object with material effects.

1. Prescribed offences (r 2A; Schedule 1A)

• The regulations specify a catalogue of offences drawn from the Australian Consumer Law, the Children and Community Services Act 2004, the Criminal Code (WA), the Human Reproductive Technology Act 1991, the Misuse of Drugs Act 1981, the Prohibited Behaviour Orders Act 2010, the Prostitution Act 2000, the Public Health Act 2016, the Restraining Orders Act 1997 and the Voluntary Assisted Dying Act 2019 (Schedule 1A).
• Reg 2A(1)(b) and (c) extend the prescription to conspiracies, attempts and incitement, and to offences under Commonwealth or out-of-state law where the underlying conduct would have been an offence in WA.

2. Interstate orders (r 2B)

• The regulations list specific statutory provisions from other Australian jurisdictions that will be treated as "interstate interim prohibition orders" and "interstate prohibition orders" for the Act’s purposes (r 2B(1)-(2)). This is mechanistic recognition of counterpart orders made by health complaints bodies interstate.

3. Prescribed time, providers and form (rr 3-5; Schedule 2)

• The "prescribed time" is set at 31 days for s 75(1) (r 3). The regulations then identify particular persons and classes to whom s 75(1) applies (r 4). The prescribed form for s 75(2) is Form 1 in Schedule 2 (r 5). Schedule 2 includes a detailed annual return template, requires returns to be given to the Director by 31 July each year and specifies a comprehensive set of categories, demographic tags and outcome/time-to-resolution bands.

4. Code of conduct (r 6; Schedule 3)

• Schedule 3 prescribes a code of conduct applicable to health care workers who are not registered providers and to registered providers when providing services unrelated to their registration (r 6). The code sets behavioural and administrative expectations: competence, scope of practice, consent, prohibition on misleading claims, infection control, adverse event response, recordkeeping, indemnity insurance and a display obligation with specified exemptions (Schedule 3, clauses 1-17).

5. Exemptions and scope limits

• Clause 17(3) of Schedule 3 lists premises excluded from the display obligation (public health service premises as defined in Health Services Act s 6, private hospitals other than nursing homes under the Private Hospitals and Health Services Act 1927 s 2(1), St John Ambulance premises, and approved providers under the Commonwealth Aged Care Act 1997 Schedule 1 cl 1).

These concepts knit into the Act’s complaint and prohibition powers. The regulations do not, however, themselves create the Act’s investigatory or sanctioning powers. They supply the lists and administrative tools the Act references; their practical effect is to widen the class of misconduct and the set of interstate orders that can feed into the Act’s machinery, and to require certain providers to collect and report standardised complaints information and to observe a code of conduct in specific contexts.

The regulations create obligations and expectations that fall on a range of actors. Identify who pays, who decides and the likely behaviour changes.

Primary groups affected

• Prescribed providers and classes (r 4): the chief executive officer of the department principally assisting in the administration of the Prisons Act 1981; the chief executives of St John Ambulance WA Ltd, Royal Flying Doctor Service (Western Operations) and Silver Chain Nursing Association Inc; public health service providers established under the Health Services Act 2016 s 32(1); and managers or chief executives of private hospitals listed in Schedule 1 (r 4(1)-(2), Schedule 1). These named organisations will have obligations under s 75 of the Act as glossed by regs 3-5, principally to provide the prescribed return (Schedule 2). Therefore organisations’ executive offices carry compliance responsibility: the regulations call out "chief executive" roles as the unit that must act.

• Health care workers in private practice and non-registered providers (r 6; Schedule 3): the code of conduct applies to health care workers who are not registered providers and to registered providers who provide services unrelated to their registration (r 6). That captures independent practitioners operating outside professional registration scope, alternative therapy practitioners who are not registered, and registered practitioners when they offer services not linked to their registration. These workers must comply with the code’s obligations (consent, infection control, recordkeeping, insurance, not providing services outside competence, advertising substantiation, display requirements subject to exceptions).

• Managers and CEOs of private hospitals (Schedule 1): the inclusion of listed private hospitals as a prescribed class for s 75 means their managers or CEOs must engage with the annual return process, which likely requires collection and aggregation of complaint data from their facilities.

• The Director of the Health and Disability Services Complaints Office (Schedule 2): recipients of the prescribed annual returns and the authority to use the returns in the operation of the Act. The regulations explicitly require the return to be given to the Director by 31 July each year (Schedule 2).

Secondary or consequentially affected parties

• Complainants and users of health services: the Schedule 2 return requires demographic and complaint category breakdowns (age bands, gender, Aboriginal or Torres Strait Islander status, postcode bands, complaint categories). Data collection for the return will touch on privacy and data-handling obligations and may change how organisations gather and store complaint data.

• Registered health boards and insurers: the code’s requirements for indemnity insurance (Schedule 3, clause 16) and recordkeeping (clause 15) will intersect with professional registration standards and insurance markets. Insurers may see clarified risk exposure for unregistered practitioners or for services provided outside registration.

• Interstate health complaints bodies: the regs specify that certain interstate orders count as interstate orders for the purposes of the Act (r 2B). That recognition affects practitioners who have been the subject of interstate prohibition or interim prohibition orders because such orders will now operate within the Act’s interstate recognition framework.

Who decides and who enforces

• The regulations do not themselves set out enforcement penalties. They calibrate the triggers and inputs for the Act’s decision-makers, most notably the Director of the HDSCO and the decision-making powers located in the Act (see regs 2A and 2B referencing Act ss 52B, 52H, 52Q, 52R and s 75). In practice, the Director and any decision-maker under the Act will use the lists, prescribed timeframes and code when exercising functions under the Act.

Behavioural effects

• Data and reporting: prescribed returns and the 31-day prescribed time for s 75(1) (r 3 and Schedule 2) force certain providers to collect more granular data and meet a calendar-driven delivery date (31 July for the year ending 30 June). Organisations will need administrative processes to gather data across complaint categories and demographic tags.

• Standardisation and compliance: the code of conduct standardises expectations for non-registered and out-of-scope registered providers. Practitioners will have to adjust advertising, recordkeeping, consent processes and infection control practices to align with Schedule 3.

• Recognition and portable effect of interstate orders: practitioners subject to interstate orders listed in r 2B may find those orders carry recognized effect in WA under the Act. That can change the consequences practitioners face across jurisdictions.

The immediate payers of administrative cost are the prescribed providers who must prepare and lodge Schedule 2 returns, and the individual health care workers who must adopt the code where it applies. Decision-makers at the Director’s office are the primary actors who will use the supplied information and lists to operate the Act’s complaint and prohibition mechanisms.

The regulations impose specific duties and clarify certain rights through the form, lists and code they prescribe. Below are the key duties and practical rights traceable to the reg text.

Key duties

• Annual return requirement (Schedule 2; rr 4-5)

  • Duty: Providers prescribed by r 4 (chief executives and prescribed classes) must complete and give the annual return set out in Form 1 in Schedule 2 to the Director of the Health and Disability Services Complaints Office by 31 July for the year ending the previous 30 June. Schedule 2 specifies the return must relate to complaints received in that year, whether resolved or not. The return requires counts across extensive categories: complainant relationship to user, demographic breakdowns (gender, age bands, Indigenous status, postcode ranges), detailed complaint categories (access, communication, decision making, quality of clinical care, costs, rights/respect/dignity, grievances, corporate services, misconduct, carers), outcomes (apology, compensation, practice changes, counselling provided, withdrawn, unresolved) and time-to-resolution bands.
  • Practical duty-holders: chief executives of named organisations and managers/CEOs of private hospitals listed in Schedule 1, and the class of health service providers under Health Services Act s 32(1) (r 4(1)-(2); Schedule 1).

• Display obligation (Schedule 3, clause 17)

  • Duty: Health care workers to which the code applies must display or make available a copy of the code and a document that gives information on how clients may make a complaint to the HDSCO at all premises where they carry on practice, in a visible or accessible manner (Schedule 3, cl 17(1)-(2)).
  • Exceptions: clause 17(3) lists premises to which this obligation does not apply (certain public health service premises, private hospitals other than nursing homes, St John Ambulance premises, and approved providers under the Aged Care Act).

• Conduct obligations (Schedule 3, clauses 1-16)

  • Duties include maintaining competence and practising only within training and experience (clause 1); obtaining appropriate consent (clause 2); not dissuading a client from medical treatment and cooperating with other providers (clause 3); reporting colleagues to HDSCO when a reasonable belief exists that another worker has placed clients at serious risk of harm (clause 4); taking timely remedial action and notifying clients and, if appropriate, authorities after adverse events (clause 5); adopting infection control precautions and complying with specific regulations for skin penetration (clause 6); seeking advice and modifying practice when diagnosed with transmissible conditions (clause 7); not claiming to cure cancer or terminal/incurable illnesses without substantiation (clause 8); not misinforming clients about qualifications, competence or treatment efficacy (clause 9); not providing services while impaired by alcohol or illicit substances (clause 10); not providing services while suffering from a mental or physical impairment that places clients at risk (clause 11); not financially exploiting clients (clause 12); not engaging in sexual or improper relationships with clients and observing a reasonable cooling-off period after a therapeutic relationship ends (clause 13); complying with privacy laws (clause 14); keeping appropriate clinical records and facilitating client access and transfer (clause 15); and holding appropriate indemnity insurance (clause 16).

• Infection control compliance (Schedule 3, clause 6(2))

  • Duty: Practitioners who carry out skin penetration or other invasive procedures must comply with the Health (Skin Penetration Procedure) Regulations 1998.

• Reporting colleagues (Schedule 3, clause 4)

  • Duty: A health care worker who forms a reasonable belief that another has placed or is placing clients at serious risk must refer the matter to the HDSCO.

Key rights and procedural clarifications

• The regulations do not themselves confer rights of appeal, enforcement procedure or specified sanctions; those remain located in the Act. However, the regulations clarify that certain interstate orders and specified offences are relevant inputs into the Act’s powers, which may affect rights under the Act when invoked (regs 2A and 2B).

• Providers prescribed under r 4 have a right to know precisely what data must be compiled and the form to use for their statutory return (Schedule 2 supplies the exact template and deadline).

• The code of conduct contains prescriptive duties but also clarifies exceptions to the display obligation (Schedule 3, cl 17(3)), giving certain premises a practical exemption.

Implementation and compliance specifics that translate into duties

• Time: r 3 sets the prescribed time at 31 days for purposes of s 75(1) of the Act. Reg 5 then prescribes the form for returns required by s 75(2). The annual return must be given to the Director by 31 July (Schedule 2). These dates convert statutory obligations into concrete administrative deadlines.

• Scope: r 6 specifies the code applies to health care workers who are not registered providers and to registered providers when providing services unrelated to their registration. This is an explicit scope limitation and determines who must follow Schedule 3’s duties.

In short, the regulations convert statutory references into operational duties: which actors must collect and furnish standardized complaints data, what standards certain health care workers must meet, what interstate instruments and criminal offences feed into the Act’s enforcement tools, and the precise forms and timeframes that will be used by the Director when exercising functions under the Act.

The regulations themselves are not framed as a schedule of penalties. They principally prescribe lists, forms, timeframes and a code of conduct. The enforcement and sanctioning architecture remains with the Act. However, the regulations materially change the set of inputs and triggers that the Act’s enforcement mechanisms can use. Key enforcement-related elements in the regulations are the prescribed offences, the interstate-order recognitions, and the code-of-conduct obligations that can form the factual basis for complaints.

What the regulations do with enforcement inputs

• Prescribed offences for Act provisions (r 2A; Schedule 1A)

  • Reg 2A expressly states that for the purposes of ss 52B(3)(a)(ii), 52H(3)(a)(ii) and 52R(2)(a)(ii) of the Act, the listed offences in Schedule 1A are "prescribed offences" (r 2A(1)). The practical effect is that conduct falling within those offences is formally within the catalogue of misconduct that the Act references for the purposes of those particular sections.
  • Schedule 1A includes serious criminal offences (murder, sexual offences, child exploitation offences, grievous bodily harm, manslaughter), offences under consumer law (false or misleading representations), offences under health-related statutes (e.g. unauthorised performance of abortion under Public Health Act s 202MN), and a range of other offences. Reg 2A(1)(b) extends prescription to conspiracy, attempt or incitement to commit those offences; reg 2A(1)(c) captures comparable interstate or Commonwealth offences if the conduct would have been an offence in WA (r 2A(1)).

• Interstate orders (r 2B)

  • Reg 2B maps interstate statutory provisions to the Act’s definitions of interstate interim prohibition orders and interstate prohibition orders. That means an order made under the listed interstate statutory provisions will be formally treated as an interstate order under the Act, and therefore capable of being relied on in WA processes that the Act allows.

• Code-of-conduct breaches

  • The code in Schedule 3 sets standards. While the regulations do not themselves specify criminal or civil penalties for breaches of the code, contraventions of the code will be complaints the Director can receive and consider under the Act. Where a code breach intersects with a prescribed offence, or where the Act authorises prohibition orders or other measures, the code will be a normative reference point in complaint assessment and decision-making.

What the regulations do not do

• They do not themselves specify fines, imprisonment terms, administrative penalty amounts or precise disciplinary procedures. Those matters are for the Act and other enabling statutes. The regulations also do not specify the Act’s internal thresholds for exercising powers such as prohibition orders, interim orders, or the pith of investigatory processes. They provide the defined inputs and the administrative infrastructure (forms, times, lists).

Practical enforcement implications and risks

• Expanded trigger set: by listing many offences in Schedule 1A, the regulations broaden the catalogue of conduct the Act can treat as "prescribed" in the contexts mandated by ss 52B(3), 52H(3) and 52R(2). That widens the set of factual scenarios where the Act’s powers can be engaged. For regulated actors, this means that a wide range of criminal conduct, or conduct that is the subject of interstate prohibition orders, can be used to justify action under the Act.

• Inter-jurisdictional portability: r 2B’s mapping of interstate orders means decisions made by interstate health complaints bodies under the listed provisions will have formal recognition in WA channels. Practitioners with a history of interstate orders should expect those to be relevant in WA complaint processes.

• Administrative sanctions: although the regulations do not specify administrative sanctions, the code creates duties that the Director and complaint processes will evaluate. Repeated or serious breaches reflected in complaints and captured in prescribed returns might increase the likelihood of investigation, public adverse findings or action under the Act.

• Data-driven oversight: Schedule 2’s standardised returns supply the Director with systematic data. That enables trend analysis, targeting of enforcement or systemic inquiries informed by aggregated complaint types and times-to-resolution. This generates a compliance incentive for providers to proactively address root causes.

In sum, the regulations expand the informational and factual base the Act’s decision-makers will use. Enforcement consequences still derive from the Act; the regulations shape which events and facts are visible and actionable by making them prescribed, reportable or standardised.

The regulations are explicitly designed to interface with multiple statutes. They feed information and definitions into the Health and Disability Services (Complaints) Act 1995 and reference , either directly or via Schedule 1A , a suite of other Western Australian and Commonwealth laws. The regulatory instrument also implements recognition of interstate instruments. Below are the interaction points and the mechanisms by which the regulations tie into other laws.

Direct Act cross-references

• The regulations consistently reference specific sections of the Act as their purpose clauses. For example:
  • Reg 2A: prescribes offences for the purposes of ss 52B(3), 52H(3) and 52R(2) of the Act.
  • Reg 2B: prescribes interstate orders for the purposes of the definition of interstate interim prohibition order and interstate prohibition order in s 52Q(1) of the Act.
  • Reg 3: prescribes the "prescribed time" for s 75(1) of the Act.
  • Reg 4: prescribes providers and classes of providers for s 75(1).
  • Reg 5: prescribes the form for s 75(2).
  • Reg 6: prescribes the code of conduct for the purposes of s 77A. These references show the regulations function as subordinate instruments fleshing out the Act’s delegated powers.

Interplay with WA statutes via Schedule 1A

• Schedule 1A lists offences under a range of WA statutes that will be treated as prescribed offences for the Act’s purposes:
  • Australian Consumer Law (as defined by the Competition and Consumer Act 2010 (Cth) s 4(1) and the Australian Consumer Law (WA) as defined in the Fair Trading Act 2010 s 17(1)) , items such as s 151 (false or misleading representations) and ss 155-156 (misleading conduct) (r 2A(2); Schedule 1A Division 1).
  • Children and Community Services Act 2004 offences (e.g. failing to protect child from harm, body piercing on certain parts of a child) (Schedule 1A Division 2).
  • The Criminal Code (WA): an extensive list of offences from racial vilification provisions to sexual offences, violent offences, kidnapping, robbery, fraud and other serious offences (Schedule 1A Division 3).
  • Human Reproductive Technology Act 1991 (unlicensed practices and related offences) (Division 4).
  • Misuse of Drugs Act 1981 (Division 5).
  • Prostitution Act 2000 (Division 7) and Prohibited Behaviour Orders Act 2010 (Division 6).
  • Public Health Act 2016 , provision s 202MN (performance of abortion by unqualified person) added by the 2024 amendments (Division 7A).
  • Restraining Orders Act 1997 (Division 8).
  • Voluntary Assisted Dying Act 2019 (Division 9).
• The combined effect is to ensure that misconduct under a wide range of WA statutory regimes is available as a ground or trigger for action under the Act where the Act references prescribed offences.

Inter-jurisdictional recognition

• Reg 2B lists specific provisions from other States and the ACT that are to be treated as interstate orders for the Act’s purposes. The listed provisions include:
  • South Australia: Health and Community Services Complaints Act 2004 s 56B(2)(a) or (b) and s 56C(2)(a) or (b).
  • NSW: Health Care Complaints Act 1993 s 41AA(1) and s 41A(2)(a).
  • Victoria: Health Complaints Act 2016 s 90(1)/(1A) and s 95(1)/(1A).
  • Queensland: Health Ombudsman Act 2013 s 68(1) and s 90C(1).
  • ACT: Human Rights Commission Act 2005 s 94G(1) and s 94H(1).
• Mechanism: those interstate orders will be treated within WA as interstate interim prohibition or prohibition orders for the Act’s functions, enabling cross-border portability or mutual recognition in WA complaint and prohibition processes.

Interaction with Commonwealth law and privacy framework

• Schedule 3, clause 14 requires health care workers to comply with "relevant privacy laws that apply to clients’ health information, including the Privacy Act 1988 (Commonwealth)". Thus the regulations explicitly tie the conduct expectations to Commonwealth privacy obligations, which has practical implications for how Schedule 2 data (detailed demographic and complaint breakdowns) must be collected, stored and transmitted.

Interplay with regulatory standards and infection-control rules

• Schedule 3 clause 6(2) expressly ties the code to the Health (Skin Penetration Procedure) Regulations 1998 for practitioners who perform skin penetration or invasive procedures. This links the code to existing infection-control regulation and imposes a cross-compliance expectation.

Exemptions and overlaps with other regulatory regimes

• Clause 17(3) of Schedule 3 exempts certain premises from the display obligation, specifically premises of health service providers as defined in Health Services Act 2016 s 6; private hospitals (other than nursing homes) as defined under the Private Hospitals and Health Services Act 1927 s 2(1); premises of St John Ambulance WA Ltd; and premises of approved providers as defined under the Aged Care Act 1997 (Cth). Those exemptions show the regulations are conscious of overlapping regulatory settings and carve out some classes of premises where other frameworks apply or where the display obligation would duplicate other statutory requirements.

Overall interaction pattern

• The regulations act as a bridge: they bring into the Act’s orbit offences, interstate orders and precise administrative obligations drawn from or replicating provisions in other state, territory and Commonwealth laws. Practically, regulated actors will have to navigate a web of compliance obligations where the regulations amplify the Act’s reach by reference to other statutory regimes and by requiring data collection and conduct standards that overlap with professional regulation, public health rules and privacy law.

The regulations contain a compilation table that records their amendment instruments and commencement dates. Below is an ordered, source-grounded summary of the instrument’s amendment history as recorded in the compilation table and in marginal notes.

Foundational instrument and early amendment

• Health Services (Conciliation and Review) Regulations 2010 , published 21 May 2010, r 1 and r 2 commenced 21 May 2010; remaining regulations commenced 22 May 2010. The instrument was later renamed (see other notes).

• Health Services (Conciliation and Review) Amendment Regulations 2011 , published 20 May 2011; r 1 and r 2 commenced 20 May 2011; remaining regs commenced 21 May 2011. This amending instrument inserted Schedule 1 (private hospitals) and related r 4 amendments (see marginal notes indicating Schedule 1 inserted Gazette 20 May 2011).

Reprints and subsequent amendments

• Reprint 1: The Health and Disability Services (Complaints) Regulations 2010 as at 12 Aug 2011 (this reprint incorporated the 2011 amendments listed above).

• Health and Disability Services (Complaints) Amendment Regulations 2015 , published 29 Dec 2015; r 1 and r 2 dated 29 Dec 2015; remaining regs from 30 Dec 2015. Marginal notes record Schedule 2 amendments (Schedule 2 amended Gazette 29 Dec 2015 p. 5172‑3).

• Health Services (Consequential Amendments) Regulations 2016 Part 6 , published 24 Jun 2016; commencement 1 Jul 2016. Reg 4 was amended to add the Health Services Act 2016 class reference (r 4 amended: Gazette 24 Jun 2016 p. 2314).

Major 2023 amendments

• Health and Disability Services (Complaints) Amendment Regulations 2023 , SL 2023/115, published 26 Jul 2023. Reg 2A (prescribed offences) and reg 6 (code of conduct) were inserted by SL 2023/115 r 4 and r 6 respectively, and Schedule 3 (code) was inserted by SL 2023/115 r 8. Schedule 1A (prescribed offences) was inserted by SL 2023/115 r 7. The 2023 amendments are a significant package adding the code and an extensive list of prescribed offences.

2024 amendments

• Health Regulations Amendment (Abortion Legislation Reform) Regulations 2024 Pt. 2 , SL 2024/20, published 21 Feb 2024, commencement 27 Mar 2024. This instrument amended Schedule 1A: Division 7A (Offences under Public Health Act 2016) was inserted by SL 2024/20 r 5, adding item s 202MN (performance of abortion by unqualified person).

• Health and Disability Services (Complaints) Amendment Regulations 2024 , SL 2024/54, published 1 May 2024, with regulations other than r 1 and 2 commencing 2 May 2024. Reg 2B (interstate orders prescribed) was amended by SL 2024/54 r 4 (see marginal note: r 2B inserted SL 2023/115 r 4; amended SL 2024/54 r 4).

• Health and Disability Services (Complaints) Amendment Regulations (No. 2) 2024 , SL 2024/145, published 10 Jul 2024; regs other than r 1 and 2 commenced 15 Jul 2024. Division 3 of Schedule 1A (offences under The Criminal Code) was amended by SL 2024/145 r 4 (see marginal note).

Compilation and notes

• The compilation table in the regulations lists the instruments, dates of publication and commencement. Notes in the instrument specify where particular clauses and schedules were inserted or amended and the Government Gazette page references for the amendment instruments.

Practical takeaways from the amendment history

• The regulations have evolved from a 2010 instrument to incorporate broader matters over time. Major additions in 2023 included the code of conduct and the establishment of Schedule 1A. The 2024 instruments refined the list of prescribed interstate orders and extended Schedule 1A to include a public-health offence tied to abortion legislation reform and additional Criminal Code items. The amendment record therefore shows a continuing pattern: the regulations are used to keep the Act’s operational inputs current with policy and statutory changes in health and criminal law across jurisdictions.

• For compliance teams and advisers, the amendment history underlines the importance of consulting the latest consolidated regulation and reviewing amendments announced in the Gazette. The marginal notes provide the statutory instrument references to trace the policy changes.

The text of the regulations and the compilation table do not report any case law, judicial decisions, appeals or litigation directly associated with the regulations. The instrument’s "Notes" and "Compilation table" record legislative acts and amendments, but there are no reported court cases or tribunal decisions referenced within this statutory text.

What this means practically

• There is no litigation precedent recorded in the regulations themselves that interprets the new code-of-conduct clauses, Schedule 1A prescribed offences, interstate-order recognition or the operational effect of the prescribed returns. Any legal disputes about the construction, scope or enforcement of these regulations would therefore be matters for future judicial or tribunal consideration and would have to be searched for in case law databases outside the statutory text.

• Advisers must therefore rely on the plain text of the regulations, the Act they support, and any guidance issued by the Health and Disability Services Complaints Office or government explanatory material. Where ambiguity exists (for example, scope-limiting language like "reasonable belief" in Schedule 3, clause 4), the absence of reported authorities in the instrument means interpretation will depend on plain statutory construction principles, administrative guidance, or future litigation.

• The compilation table records amendment instruments and dates, which is helpful in tracking legislative intent and timing, but does not substitute for case law when interpreting contested or uncertain provisions.

For clients requiring litigation history or judicial interpretation, an external search of tribunal and superior court databases and the HDSCO’s published decisions will be necessary because the regulations themselves contain no litigation record.

Several operational pitfalls and ambiguities arise directly from the regulations’ drafting and structure. These are not value judgements but concrete risks and compliance traps that the text creates or leaves unclarified.

1. Broad scope of prescribed offences

• The list in Schedule 1A is extensive, covering many serious Criminal Code offences, consumer law offences and offences under a range of health statutes. Reg 2A(1)(b) and (c) extend prescription to conspiracy, attempt and incitement and to offences under the law of other places where the conduct would have constituted an offence in WA. Practical effect: a wide range of conduct, including attempted or conspiratorial acts and some out-of-jurisdiction conduct, can trigger the Act’s specified powers. Organisations may be surprised at the breadth of conduct that can be treated as "prescribed".

2. Data privacy and granularity of Schedule 2 returns

• Schedule 2 requires detailed demographic data (age bands, gender, Indigenous status, postcode ranges), complainant relationship categories, complaint category tallies and time-to-resolution bands. Aggregated as required, this could raise privacy and data-protection issues, especially for small providers where data may be de‑identifiable only with difficulty. Clause 14 of Schedule 3 references the Privacy Act 1988, but the regulations do not set out how providers should balance the reporting obligations against privacy law. Providers must therefore take care when compiling returns to avoid breaching privacy obligations.

3. Prescribed time ambiguity

• Reg 3 states the "prescribed time" for s 75(1) of the Act is 31 days. Without the Act’s text in the instrument, a reader must check s 75(1) of the Act to understand the consequence fully. Practically, 31 days can be a short window for complex matters and for organisations that must gather data from multiple facilities (for example, private hospital groups). The regulations do not provide for extensions or phased reporting.

4. Who carries responsibility at organisational level

• Reg 4 names "the chief executive" of certain organisations as the prescribed provider. This assigns legal responsibility to an office-holder, not merely to the organisation. This drafting choice can create governance risk since statutory obligations attach to the chief executive’s role; employers and boards should note the corporate governance significance.

5. Scope and ambiguity of "health care worker" coverage under the code

• Reg 6 prescribes the code for: (a) health care workers who are not registered providers; and (b) registered providers who provide health services unrelated to their registration. The catch-all language "unrelated to their registration" requires interpretation. Practitioners offering services on the margins of their registration may face uncertainty about whether the code applies. There is no transitional guidance or examples in the regulations.

6. Reporting colleagues with "reasonable belief"

• Schedule 3, clause 4 obliges a worker who forms a reasonable belief that another worker has placed or is placing clients at serious risk to refer the matter to the HDSCO. The threshold "reasonable belief" is standard but fact-sensitive. Workers may fear defamation risk, workplace reprisal or professional conflict if they report and are uncertain about the threshold. The regulation does not provide safe-harbour protections for reporters.

7. Display obligations and their exemptions

• Clause 17 requires display of the code and complaints information but excludes a number of premises (health service providers defined in Health Services Act s 6; private hospitals other than nursing homes; St John Ambulance premises; approved providers under the Aged Care Act). It is a practical gotcha that many large providers (for example hospitals) are excluded from the display requirement; smaller private practitioners may be included. The exemptions can cause inconsistent visible standards across settings.

8. Insurance obligation unspecified

• Schedule 3, clause 16 requires that a health care worker "ensure that appropriate indemnity insurance arrangements are in place". There is no minimum cover level, qualification of "appropriate", or requirement to evidence insurance to the HDSCO. That creates uncertainty for practitioners and insurers about what quantum and scope of cover is "appropriate".

9. Intersection with other regulatory regimes

• The code cross-references other regulations (Health (Skin Penetration Procedure) Regulations 1998) and Commonwealth privacy law. Practitioners must coordinate compliance across multiple regulatory instruments. Failure in one area (for example, inadequate infection-control practices) could trigger a complaint under Schedule 3 and provoke referral to other regulators under related laws.

10. No direct penalty schedule in the regulations

• The regulations do not contain express sanctions for contraventions of Schedule 3. That means consequences for breaches will operate through the Act’s complaint and sanction mechanisms, the content of which is not reproduced in the regulations. Practitioners cannot look to the regulations to determine the immediate sanction for a code breach; they must consult the Act.

Practical risk management recommendations follow in the "How to comply" section, but advisers should note these gotchas as specific areas requiring attention: data protection, governance assignment to named chief executives, the breadth of prescribed offences, definitional uncertainty about "unrelated to their registration", and the lack of quantitative insurance standards.

This section translates the regulations’ requirements into a practical compliance checklist and suggested steps for providers, chief executives and health care workers. All references below are to provisions in the regulations and their schedules.

1. Identify whether you are a prescribed provider or health care worker to whom the code applies

• Check reg 4 to see if you are a prescribed provider: the chief executive of the relevant departments/organisations listed in r 4(1) or included in the prescribed classes in r 4(2) (public health service providers under Health Services Act s 32(1); managers/CEOs of private hospitals in Schedule 1).
• Determine whether you are a health care worker covered by the code under r 6: the code applies to workers who are not registered providers and to registered providers for services that are unrelated to their registration.

2. Set up data collection and reporting systems for the annual return (Schedule 2)

• Template: adopt the Form 1 template in Schedule 2 as your standard return. It requires counts across wide categories: the number of complaints, referrals, who made complaints, demographic breakdowns for complainants and users, complaint categories (access, communication, decision making, clinical quality, costs, rights/respect/dignity, grievances, corporate services, misconduct, carers), outcomes and time-to-resolution bands.
• Timing: returns relate to the year ending on the previous 30 June and must be given to the Director by 31 July (Schedule 2). Note reg 3 prescribes 31 days for s 75(1) but the explicit annual return date in Schedule 2 is 31 July.
• Governance: assign a responsible officer (for example, the CE or nominated complaints manager) to collate data from facilities. For multi-site providers, develop a centralised data collection template that feeds into the Schedule 2 fields.
• Privacy: implement de-identification and data-handling processes consistent with the Privacy Act 1988 and your state privacy obligations. Consider whether aggregation thresholds are required to avoid re-identification in small cohorts (see Schedule 2 demographic breakdowns).

3. Display obligations and consumer information

• If you are a health care worker to whom the code applies, display or make available copies of the code and a document that gives information to clients about how to complain to the HDSCO at all premises where you practice (Schedule 3, clause 17(1)-(2)), unless your premises are within the exceptions in clause 17(3). Ensure materials are visible and accessible.
• For premises exempted by clause 17(3), confirm compliance obligations under any alternative regimes that may impose similar display requirements.

4. Implement code-of-conduct practices

• Consent: ensure consent procedures are contemporaneous and compliant with state law (Schedule 3, clause 2). Document consent in clinical records.
• Scope of practice and competence: maintain continuing professional development records, and institute triage/referral protocols so that services outside competence are referred to competent providers (clause 1).
• Advertising and representations: audit promotional materials and websites to remove or substantiate any claims of curing cancer or terminal illnesses or unsubstantiated treatment efficacy (clause 8 and clause 9). Retain evidentiary materials to substantiate claims.
• Adverse events and reporting: implement an adverse-event protocol that ensures timely first aid, escalation to emergency assistance when needed, disclosure to clients and reporting to relevant authorities as appropriate (clause 5). Create an internal timeline for notification to the HDSCO where that is required.
• Infection control: for skin penetration or invasive procedures, ensure compliance with Health (Skin Penetration Procedure) Regulations 1998 (clause 6(2)). Maintain records of sterilisation procedures, instrument tracing and staff training.
• Impairment and substance-use policies: establish a staff policy that requires staff to refrain from practising while impaired, and a process to obtain advice from prescribing practitioners or pharmacists where staff are on medication that may impair practice (clause 10).
• Reporting colleagues: adopt a policy that instructs staff on when and how to refer matters to the HDSCO where they form a reasonable belief of serious risk (clause 4). Provide training on the "reasonable belief" threshold and whistleblower/protections available under workplace law.
• Recordkeeping: maintain accurate, legible, up-to-date clinical records and a secure storage system; create processes for facilitating client access and timely transfer on request (clause 15). Document retention policies consistent with other statutory requirements.
• Insurance: confirm indemnity insurance arrangements and document cover; consider obtaining written confirmation from insurers that cover is "appropriate" for the scope of practice (clause 16).

5. Risk-assess prescribed offences and interstate-order consequences

• Review Schedule 1A and identify whether the organisation’s or employees’ operational risks implicate any of the listed offences. Where staff or contractors operate in areas covered by these offences (for instance, services to children, controlled substances, reproductive technology, or activities that could attract consumer-law prohibitions), build compliance controls accordingly.
• If practitioners have been subject to interstate orders in the jurisdictions listed in reg 2B, expect those orders to be recognised under the Act in WA processes. Incorporate interstate-order checks into credentialing and recruitment vetting.

6. Governance and assigned responsibilities

• If you are the named "chief executive" in r 4(1), confirm internal delegation arrangements and ensure legal counsel reviews the statutory obligation attached to the office. Document delegation of day-to-day compliance tasks, but be aware the regulatory text names the office-holder as the prescribed provider.

7. Training and operationalisation

• Provide staff training on the code’s expectations: consent, scope of practice, infection control, recordkeeping, not providing services while impaired, and not making unsubstantiated efficacy claims.
• Create a playbook for complaint handling that maps internal steps to the categories in Schedule 2 for reporting purposes.

8. Audit and periodic review

• Conduct an internal compliance audit annually timed with the Schedule 2 reporting cycle to ensure data capture, privacy compliance and completion of the Form 1 template.
• Keep a change log for regulatory developments recorded in the compilation table; the regulations have been amended multiple times in 2011, 2015, 2016, 2023 and 2024 (see "Amendment history").

Checklist summary

• Determine whether your organisation or worker is captured by regs 4 and 6.
• Establish a complaints data collection system mapped to Schedule 2 fields and deadline (31 July).
• Review and revise advertising and promotional materials to eliminate unsubstantiated claims.
• Implement infection control and skin-penetration compliance measures.
• Ensure indemnity insurance is in place and documented.
• Display the code and complaints information where required, and note exemptions.
• Train staff on reporting thresholds for adverse events and concerns about colleagues.
• Review Schedule 1A and r 2B for offences and interstate orders that may affect your operations.
• Document delegations and governance responsibilities for chief executives named in r 4.

Following these steps will align providers and health care workers with the explicit duties in the regulations and prepare them for the Act’s complaint and prohibition procedures that rely on the regulations’ prescribed inputs.