Governance and accountability framework

Ahpra’s governance structures are consistent with it being a body corporate with a public function and reflect the legislative framework in which it operates. Ahpra has several oversight committees (the Ahpra Board and each of its committees), each of which is governed by its own charter and has roles and responsibilities to oversee the effective and efficient performance of Ahpra’s regulatory role. Such committees provide independent scrutiny of Ahpra and assess Ahpra’s implementation of internal control and governance systems.

The Ahpra Board is established under section 29 of the National Law. It is Ahpra’s governing body and is responsible for achieving Ahpra’s statutory objectives. The Ahpra Board is appointed by the Ministerial Council and is overseen by a Chair. The Ahpra Board is governed by the Ahpra Board Charter, which sets out its purpose, responsibilities and functions.

The Ahpra Board decides Ahpra’s policies (subject to any directions from health ministers) and ensures Ahpra performs its functions in a proper, effective and efficient way. The Ahpra Board appoints the Chief Executive Officer (CEO) who is responsible for the day-to-day management of Ahpra.

Under section 29 of the National Law, the Ahpra Board must consist of at least five members, including:

• a Chair who has not been a registered health practitioner in the past five years
• at least two members who have expertise in health, or education and training, or both
• at least two members who have never been registered health practitioners and who have business or administrative expertise.

There are currently seven members of the Ahpra Board. All are appointed by the Ministerial Council following a recruitment process. Members are appointed for a maximum three-year term. The membership requirements support the fair participation of different interests in the decision-making process of the Ahpra Board. The diversity of the membership ensures that no group is inadvertently excluded from the decision-making process and is a fair representation of community expectations.

Members of the Ahpra Board:

• act impartially and in the public interest when performing their functions and must put the public interest before the interests of particular practitioners or organisations that represent practitioners, and
• disclose any interest (pecuniary or other, direct or indirect) in a matter being considered and (unless the Board decides otherwise) are not present when the matter is considered.

Sub-committees of the Ahpra Board

• Finance, Audit and Risk Management Committee (FARMC)
• Regulatory Performance Committee (RPC)
• People and Remuneration Committee (PARC)
• Accreditation Committee.

These sub-committees do not make final and binding decisions on the matters brought before them; rather, they make recommendations to the Ahpra Board. The Ahpra Board makes the final decision on all matters, taking into account recommendations made by, and advice from, these sub-committees.

Finance, Audit and Risk Management Committee

FARMC is the principal sub-committee of the Ahpra Board for overseeing risk management at the enterprise level. FARMC is governed by the Finance, Audit and Risk Management Committee Charter, which details its purpose, responsibilities and functions.

FARMC consists of up to seven members including at least:

• one member who is a chartered accountant with audit experience
• up to three members of the Ahpra Board
• three members of National Boards.

FARMC is responsible for providing leadership, strategy and assurance in relation to:

• the financial strategy, performance and sustainability of Ahpra
• the integrity and acceptability of Ahpra’s financial statements
• overseeing and ensuring Ahpra has an effective and independent audit and risk assessment function at the National Scheme-wide level
• advising the Ahpra Board on governance, risk management and internal control processes, and
• internal processes and controls for ensuring compliance with legislation, codes of conduct and reasonable community expectations.

FARMC is also the contact point for the external auditors, including but not limited to reviewing the external auditors’ report and making recommendations to the Ahpra Board about any unresolved concerns. Ahpra uses the Victorian Auditor-General’s Office (VAGO) to conduct external audits.

Regulatory Performance Committee

RPC is a sub-committee of the Ahpra Board that assists in overseeing the management of regulatory performance, including registration, notifications and compliance matters and advising on regulatory performance measures and associated performance reports. RPC is governed by the Regulatory Performance Committee Charter, which details its purpose, responsibilities and functions.

RPC consists of:

• up to four members of the Ahpra Board
• at least five chairs of National Boards (including the high-volume National Boards and one lower volume National Board)
• a community member of a National Board.

RPC is responsible for providing advice and recommendations in the following areas:

• strategic regulatory operational policy informed by Ahpra and the National Boards
• risk settings and management, including mitigation strategies and triggers for action and escalation
• Ahpra’s regulatory performance and strategies of addressing policy and performance issues, and
• regulatory performance reporting to National Boards and external stakeholders.

People and Remuneration Committee

PARC is a sub-committee of the Ahpra Board that provides oversight of strategy and performance in relation to people, capability and culture within the National Scheme. PARC is governed by the People and Remuneration Committee Charter, which details its purpose, responsibilities and functions.

PARC consists of up to eight members including, at least:

• the Chair of the Ahpra Board
• up to three other members of the Ahpra Board
• up to three National Board members
• an independent member.

PARC is responsible for providing advice and recommendations in the following areas:

• capability and culture
• diversity and inclusion
• health, safety and wellbeing
• strategic workforce planning, and
• remuneration and performance management framework for the CEO and senior managers on individual contracts.

Accreditation Committee

The Accreditation Committee is the fourth sub-committee of the Ahpra Board; it provides independent and expert advice on accreditation reform and other National Scheme accreditation matters to National Scheme entities. The Accreditation Committee is governed by the Accreditation Committee Charter, which details its purpose, responsibilities and functions.

The Accreditation Committee has an independent chair and members who are drawn from categories determined by Ministerial Council. The membership categories are:

• an external accreditation/education expert
• a nominee of the Australian Commission for Safety and Quality in Healthcare
• a nominee of Universities Australia
• two nominees of the Health Professions Accreditation Collaborative Forum
• two Ahpra Board members
• two National Boards' representative
• a Jurisdictional representative
• a private healthcare employer
• a nominee of the Tertiary Education Quality and Standards Agency
• a consumer/community member, and
• a member who identifies as Aboriginal and/or Torres Strait Islander.

The Accreditation Committee is responsible for:

• providing independent and expert advice on accreditation reform and other National Scheme accreditation matters to the National Scheme
• supporting implementation of Health Ministers’ February 2020 response to the recommendations of the Independent Review of Accreditation Systems Final Report
• providing a forum for advice on significant whole-of-scheme accreditation issues including governance, accountability, and transparency, and
• providing jurisdictions and relevant stakeholders with information on how National Scheme entities and relevant external entities are taking the committee’s advice into account.

There are five senior executives who report to Ahpra’s CEO. They are:

• Chief Financial Officer
• Chief Technology Officer
• Executive Director Regulatory Operations
• Executive Director Strategy, Policy, and Health Workforce
• Executive Director People and Culture.

Together with the CEO, they form Ahpra’s National Executive (NE).

NE is the main national leadership group within Ahpra. It exists to make decisions and provide advice to the CEO and through the CEO to the Ahpra Board on:

• strategic and corporate operational objectives and policies
• overall resource management and priority setting
• quality standards and requirements
• the performance of Ahpra, and
• financial and risk management matters.

Collectively, NE is responsible for decision-making about cross-directorate and organisational-wide issues. NE has the authority to issue directions to all directorates through established management structures.

Ahpra and the National Boards regularly consult with advisory groups to gather feedback, information and advice on a wide range of issues. These groups include:

• Community Advisory Council
• Education Provider Reference Group
• Expert Panel on Drug and Alcohol Screening
• Prescribing Working Group
• Professions Reference Group, and
• Scheduled Medicines Expert Committee.

Each of the above groups is designed to ensure the interests of a wide range of stakeholders are considered in the decision-making process.

Ahpra is a separate entity from the Commonwealth government. It is not an instrumentality or agency of the Commonwealth government. It is not established under Commonwealth legislation and is not funded by the Commonwealth.

Ahpra is not part of any state or territory government department. However, Ahpra is a body established by state and territory laws and performs public functions under those laws.

Under the National Law, Parliament has conferred functions and powers on Ahpra. Ahpra:

• is a body corporate with perpetual succession
• has a common seal
• may sue and be sued in its own name
• has power to enter into contracts, and
• may acquire, hold, dispose of, and deal with, real and personal property.

Accountability to the Australian Parliament and others

Ahpra is accountable to Parliament through a Ministerial Council comprising health ministers from each state and territory and the Commonwealth, which oversees the National Scheme under the National Law. They currently meet as the Health Ministers Meeting (HMMs) (formerly the Council of Australian Governments (COAG)).

The HMMs will periodically issue communiqués, policy directions, guidance and directives relevant to the National Scheme. The HMMs also decide reforms to the National Law.

Ahpra is also accountable to the Jurisdictional Advisory Committee and may from time to time be subject to oversight by Senate inquiries.

In addition to oversight by Parliament and the relevant minister, Ahpra’s decisions can be subject to review by the courts, state-based administrative tribunals, and the National Health Practitioner Ombudsman (NHPO). The NHPO acts as an independent external person overseeing the discharge of Ahpra’s regulatory functions and Ahpra’s privacy compliance (including the handling of personal information).

Statutory obligations

Ahpra is subject to a range of statutory obligations relating to corporate, financial and regulatory obligations.

Corporate

The Delegation, Sub-delegation and Administrative Authorisation Manual (the Delegation Manual) is an internal ‘rule book’ that assists Ahpra to provide a robust system of corporate governance and accountability. The Delegation Manual ensures that a consistent approach is taken to the development, amendment and implementation of decisions under the National Law and related general, human resources and financial decisions.

Ahpra is required to prepare annual reports¹ that include financial statements and detail on Ahpra’s performance. Annual reports are provided to HMMs and tabled in the Parliament of the Commonwealth and each participating jurisdiction.

Finance

Ahpra is financially separate from state, territory and Commonwealth governments. Ahpra holds funds for itself and the Boards, and those funds are not part of the consolidated revenue of any government. Section 208(1) of the National Law establishes the Australian Health Practitioner Regulation Agency Fund (the Agency Fund).

The National Law imposes certain obligations on Ahpra and the National Boards regarding the management and use of the Agency Fund. The financial arrangements under the National Law (in very broad terms) are as follows:

• Ahpra receives money paid under the National Law (for example, fees, fines and costs recovered under the National Law), as well as government grants and interest on money and assets it holds
• most of the money Ahpra receives is in the form of registration fees
• Ahpra holds the money it receives in the Agency Fund and is responsible for investing and managing that money
• when Ahpra receives fees for a particular Board, it allocates those fees to an account it holds for that Board (within the Agency Fund)
• Ahpra has general power to pay money out of the Agency Fund to meet the expenses of administering the National Law, and
• even though Ahpra is not subject to detailed government financial and auditing legislation, the National Law imposes duties to manage operations efficiently, effectively, economically and in an accountable way. Ahpra is routinely audited by a public sector auditor, namely VAGO.

The Agency Fund

The National Law sets out the following rules for the Agency Fund:

• the Fund is to have a separate account for each National Board
• the Fund is to be administered by Ahpra
• Ahpra may establish accounts with any financial institution for money in the Fund, and
• the Fund may only be invested as provided for in s 211 of the National Law.

The National Law establishes the Agency Fund to receive:

• all money appropriated by a Parliament for the purposes of the Agency Fund
• all fees, costs and expenses paid or recovered under the National Law
• all fines paid to, or recovered by, a National Board
• the proceeds of investments of the Fund
• all grants, gifts and donations made to Ahpra or a National Board
• all money directed or authorised to be paid into the Fund under a law, and
• any other money or property received by Ahpra or a National Board in connection with the exercise of its functions.

Monies may be paid out of the Fund to:

• pay costs incurred in administering or enforcing the National Law
• make payments to co-regulatory authorities, and
• make any other payments approved by the Ministerial Council (where recommended to the Council by Ahpra or a Board).

Regulatory

The National Boards have the power to delegate their regulatory powers under the National Law. These delegations are contained in:

• each of the National Board’s Instruments of Delegation, by which each Board delegates powers to its committees and/or Ahpra, and
• the Ahpra CEO Instrument of Subdelegation, which further subdelegates National Boards’ powers to specific Ahpra positions.

Members of the National Boards and their committees have similar obligations as members of the Ahpra Board including that they:

• are bound by an ongoing duty of confidentiality²
• are required to act in the public interest³, and
• must disclose any conflict of interest⁴, including in relation to the consideration of regulatory matters.

The National Law stipulates that National Boards must engage in a consultation process when developing registration standards, codes and guidelines. At the conclusion of the consultation process, consultation reports are published on the Ahpra webpage, demonstrating transparency in the decision-making process of the National Boards.

The Regulatory Guide (the Guide) comprehensively sets out how Ahpra and the National Boards manage notifications about the health, performance and conduct of practitioners in accordance with Part 8 of the National Law. The Guide is intended to explain the decision-making framework in a clear and transparent manner. The Guide provides the public with information about how certain regulatory decisions are made, ensuring that Ahpra and the National Boards make impartial decisions consistently with the principles set out in the Guide.

Other legislation

Freedom of Information Act 1982

Ahpra is subject to the Freedom of Information Act 1982 (Cth) (as modified by the National Law) (FOI Act). Under the FOI Act there is a requirement to publish documents as required by the Information Publication Scheme for Australian Government Agencies. As a result, Ahpra publishes a wide range of its internal governance and policy documents on its website so they are available to the public.

Public interest disclosure (PID)

All states and territories have public interest disclosure legislation (PID Legislation) that governs public interest disclosures (PIDs), but not all of these Acts apply to Ahpra and the Boards. PID Legislation aims to protect people who make PIDs about serious wrongdoing in the public sector (also known as ‘whistleblowers’).

Ahpra has established a policy for dealing with PIDs, which is designed to encourage any person who has a serious concern about possible improper conduct or corrupt conduct in the administration of the National Law to disclose that concern.

The Policy is available on Ahpra’s webpage.

¹ National Law, section 8.
² National Law, section 216
³ National Law, Schedule 4, Clause 7
⁴ National Law, Schedule 4, Clause 8

Ahpra’s Code of conduct (the Code) and associated policies guide and inform the expected behaviour of Ahpra employees. Ahpra’s values of respect, integrity, collaboration and achievement underpin the way that all employees are expected to work, make decisions and interact with others. The Code imposes responsibilities on Ahpra staff, including the requirement to seek permission for secondary employment, as this may give rise to an actual, potential or perceived conflict of interest. Adherence to the Code, associated policies and procedures, and Ahpra’s values fosters a culture of integrity, as a consistent standard of behaviour is expected in the actions and decisions of staff.