When is a Health Practitioner Not "a Fit and Proper Person" to Practise Their Health Profession in Australia?

Prior to implementation of the Health Practitioner Regulation National Law Act 2009 (Qld) (National Law) the term "good character" was used in the statutory regulation of health practitioners in Australia. "Good character" has been jettisoned in the National Law and replaced with the concept of "fit and proper person". The term "fit and proper person" plays an important role in the regulation of health practitioners under the National Law. "Fit and proper person" is not defined in the National Law but case law has narrowed the term to refer to "moral integrity" and "rectitude of character". These considerations can be applied in the context of application for registration, immediate action, and disciplinary proceedings in relevant tribunals. Application of the "fit and proper person" test serves to enhance public confidence in the integrity of the health professions and the integrity of the regulatory regime, as distinct from protecting the public from unsafe and incompetent health professionals.

Investigating Investigation Powers under the Health Practitioner Regulation National Law

Investigators and inspectors appointed under the Australia Health Practitioner Regulation National Law play important roles by gathering and assessing evidence used in disciplinary proceedings and/or criminal prosecutions. In performing these roles, investigators and inspectors exercise "police-like" powers including coercive questioning and entry onto private property with or without a search warrant. The investigation process can add additional stress and anxiety for health practitioners who are subject to disciplinary proceedings. It is difficult for an aggrieved party to challenge the lawfulness of the exercise of an investigation power in a tribunal as tribunals lack jurisdiction to rule on the legality of an investigation power or the admissibility of evidence. This article explores the range of powers possessed by investigators and inspectors under the National Law and a number of issues relating to the exercise of those powers.

Criminal and civil community-based "detention": some parallels

Over the last 20 years, governments in Australia and elsewhere have increasingly embraced the notion of community-based treatment of the mentally ill in preference to detention in a mental health facility. At the same time, governments have also embraced the notion of community-based treatment and punishment of criminal offenders in preference to detention in a custodial facility. This article examines the use of Community Treatment Orders (CTOs) within the Victorian mental health regime, and the use of Intensive Correction Orders (ICOs) within the Victorian criminal justice regime. It is argued that a number of striking similarities can be found in the respective legislative schemes and policy considerations.

Risks associated with herbal slimming remedies

The market for non-conventional, natural herbal medicines is growing. This marketing opportunity has been seized upon by some unscrupulous practitioners to sell potentially unsafe 'herbal' products. Several people attended a Chinese herbalist for weight loss advice and were sold 'herbal' preparations that contained fenfluramine, a drug which was withdrawn from sale in the West in 1997 after its use was linked to primary pulmonary hypertension and valvular heart disease. Adulteration of Chinese medicines with Western drugs is becoming an increasing problem, and deaths have been reported from Japan and other Far Eastern countries linked to Chinese slimming aids containing N-nitroso-fenfluramine. There is a need for increased public awareness of such risks associated with the use of unlicensed medicines; a system of registration for medical herbalists is also required to protect both the reputable practitioners and the general public.

Should we still be doing duplicate immunoassays?

To determine whether, with improvements in radioimmunoassay techniques, duplication is still necessary, the differences between duplicate results for a range of assays done routinely over one month were examined retrospectively. Differences over 10% between duplicates were found in 104/779 (13%) of assays for thyroid stimulating hormone, 27/180 (15%) for total thyroxine, 44/378 (12%) for cortisol, 15/355 (4%) for follicular stimulating hormone, 20/356 (6%) for luteinising hormone, and none for alpha fetoprotein (0/256). In only two of 779 patients (0.26%) would the different result of a pair of thyroid stimulating hormone duplicates have led to different courses of action by the laboratory. None of the other differences in any assay would have resulted in a potential misclassification. Although replication of assays will give more correct results by pure scientific criteria, the improvement is rarely clinically important and the financial cost is considerable.