Ahpra registration is among seven options state and territory health ministers have put on the table as they consult on the future of audiology regulation in Australia, with a final paper to be presented to health ministers in July 2024.
Shortlisted options being posed for feedback include the current model of self-regulation, national registration of the entire audiology profession through the National Registration and Accreditation Scheme (NRAS) under the Australian Health Practitioner Regulation Agency (Ahpra), as well as more targeted regulation of practitioners offering certain services.
In Australia, Audiology is currently self-regulated with accreditation occurring through professional practitioner bodies. Meanwhile, about 800,000 practitioners from 15 other health professions – including optometrists, doctors, physiotherapists and pharmacists – are regulated under the NRAS whose main role is to protect the public from harm.
The catalyst for the review was audiology failures through incorrectly programmed cochlear implants received by children in Townsville and Adelaide.
Four of seven options in the Queensland Health Consultation Paper Audiology Decision RIS (regulatory impact statement) are shortlisted for the hearing health sector and the public to consider:
- The status quo (certification under the National Alliance of Self-Regulating Health Professionals – NASRHP)
- Regulation specific to audiologists who perform paediatric diagnostic and cochlear implant care services
- Jurisdictional registration of the audiology profession requiring audiologists to register in their jurisdiction to practise
- National registration of the entire audiology profession through the National Registration and Accreditation Scheme (NRAS) (under the Australian Health Practitioner Regulation Agency – Ahpra. To be registered with Ahpra, a profession must be assessed for eligibility into NRAS.)
Now underway, national sector and stakeholder consultation is being led by the Queensland Government with the final decision statement to be developed in June and presented to health ministers in July.
Audiology and audiometry impacts
In an article posted on the Audiology Australia (AudA) website, Ms Leanne Emerson AudA CEO, said state and territory health ministers had opened a targeted consultation to inform the statement which is considering regulatory and non-regulatory options for the future of the profession.
“Announced in May 2024, the review is being led by Queensland Health, and we understand it will consider impacts to both audiology and audiometry,” she said.
“Audiology Australia is not and has never been against the profession achieving registration and we continue to raise the issue with (the Federal) Government. The response has remained the same – it is a low-risk profession and doesn’t meet the six criteria for registration.”
There were advantages and disadvantages to registration, AudA said on its website, and areas that remained unaddressed in any regulatory and self-regulatory models. Any resulting change was likely “years away.”
Protection of title, higher fees
AudA said that without confirmation of the entire scope of changes, the extent of changes under registration was somewhat ambiguous but broadly registration would allow for protection of title, and a clear pathway for raising complaints across the whole profession.
However, it may also result in higher fees, higher insurance premiums, noting that only ‘high risk’ professions are regulated under NRAS, and less flexibility and autonomy around scope of practice.
Queensland Health has engaged Deloitte to conduct the process which will include consultation, development and presentation of the statement. A Deloitte spokesperson told Hearing Practitioner Australia the paper was under development with nationwide consultations to occur from 8-31 May 2024.
“Any decisions on the recommended option will take into account consultation feedback and guidance from the Office of Impact Analysis,” the spokesperson said. “There are several options being considered which will be outlined shortly during the public submission process.”
The statement would be developed in June, drawing on consultation, and presented to the health ministers meeting on 26 July 2024.
Prioritise safety
Deafness Forum Australia said regulation was needed to prioritise safety as “the catalyst for considering regulation of the audiology profession was audiology failures in Townsville and Adelaide children’s hospitals prompting millions (of dollars) in compensation to families and lost learning years for children” through wrongly programmed cochlear implants.
Independent Audiologists Australia has also lobbied strongly for regulation by 2026, saying, “the need for external regulation of audiology as a specialist allied health profession has never been more pressing” and “Ahpra registration would establish clear standards, ensuring only qualified professionals provide hearing healthcare services.”
However, Emerson said independent reports around these incidents pointed to wider, systemic failings across the health sector as significant contributing factors and it was insufficient and inadequate to point only to registration as remediation.
AudA said other key reviews were also underway including the Allied Health Scope of Practice, falling out of the Strengthening Medicare Reforms, and the Allied Health Clinical Governance review.
“This increased scrutiny has sparked renewed discussion about regulation of the profession,” the organisation said. “Importantly, we need to work together with governments and consumers to ensure these types of incidents do not continue to occur.”
AudA and the Australian College of Audiology were invited to consult on the review with public feedback sought through the Queensland Government website.
Inaccuracies identified
AudA said it had “identified many inaccuracies” in the document which it would seek to address in its consultation feedback and provide context and detail to give more complete understanding of impacts of each option for the profession.
“We want to ensure this review is clear about not only the problem it seeks to solve, but the effectiveness of the proposed options to address it. The arguments are complex and nuanced. For example, any decision to regulate the profession will likely involve both audiology and audiometry and if it doesn’t, what does that mean for businesses which employ both professions?” AudA said.
“Other misnomers include that registration will provide a vehicle for addressing (perceived or real) unethical practices by businesses, simplify HSP processes, or regulate the processes and structures in primary care. Advantages that regulation may offer audiology – title protection, increased profile and improved access to referral and prescribing rights – can also be achieved outside the Ahpra model.”
In an article published on the AudA website, Ms Eleanor Hoskins, AudA policy and advocacy manager, has detailed pros and cons of regulation, a debate she writes is complex. Striking a balance between regulation and flexibility, she writes, is essential to support patient safety, high professional standards, and advancement of the audiology sector.
“Ultimately, the goal should be to have a regulatory environment that optimises the delivery of high-quality audiological services while promoting innovation and accessibility for all Australians,” she said.
Some may see audiology as an ‘unregulated’ profession, she said, but the sector was regulated through key standards facilitated by AudA and NASRHP, plus adherence to standards in the National Code of Conduct for Health Care Workers which ensured compliance with professional standards, certification, accreditation and public safety.
Deafness Forum Australia said people who had not received an invitation to participate in interviews and focus groups (during the May consultation phase) who think they should be involved could email AudiologyRIS@deloitte.com.au.
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