Ahpra and Medical Board announce review of cosmetic surgery checks and balances

30 Nov 2021

Cosmetic surgery has rapidly grown as a multi-million-dollar entrepreneurial industry. This has given rise to practices and marketing methods by some registered health practitioners which raise significant patient safety concerns. 

This review will consider existing regulation and regulatory practices in use by Ahpra and the relevant National Boards to ensure they keep pace with rapid changes in the cosmetic surgery industry and to make recommendations for any required changes to better protect the public. 

Health Ministers have already committed to national consultation on changing the National Law to protect the title of ‘surgeon’. Ahpra and the Board have welcomed this. 

State and territory health authorities have a major regulatory role in licensing facilities in which cosmetic surgery is being performed. The review will look at ways to improve communication and cooperation between agencies involved in the current system of checks and balances in cosmetic practice and how the reporting and safety culture of cosmetic surgery can be improved.  

Ahpra CEO Martin Fletcher said: ‘Some worrying features of the cosmetic industry set it apart from conventional medical practice, including corporate business models which are alleged to place profit over patient safety, no medical need for cosmetic procedures, limited factual information for consumers and exponential growth in social media that emphasises benefits and downplays risks,' Mr Fletcher said. 

‘This review will ensure that the specific regulatory responsibilities of Ahpra and National Boards are effectively protecting the public in our part of the regulatory system for cosmetic surgery’. 

The review will consider the current risk-based regulatory framework of Ahpra and National Boards, including the current codes of conduct, the notifications and investigations protocols, and management of advertising offences in relation to cosmetic surgery. 

Medical Board of Australia Chair, Dr Anne Tonkin, said the Board was concerned there may be a weak safety and reporting culture in cosmetic surgery. 

‘It’s a very good thing that there are doctors, nurses and other health professionals who are picking up the pieces when patients’ cosmetic procedures go wrong. But to keep patients safe, we really need to understand why these practitioners are not always sharing their patient safety concerns with us in a timely way,’ Dr Tonkin said.  

‘If we know where the issues are, we can do something about them to keep patients safe,’ she said. 

Mr Andrew Brown will lead the review once he finishes in the role of Queensland Health Ombudsman in January 2022.The review will report by mid-2022. 

Mr Brown has 30 years’ experience in the public sector, primarily in legal services, regulatory oversight and complaints management. He has extensive experience in public administration and designing and implementing effective and efficient regulatory and complaints management processes.  

‘I am pleased to lead this timely review to ensure safer patient outcomes. I hope that the review will support the work of all regulators in the cosmetic surgery industry to ensure high quality and safe care.’ Mr Brown said.  

Other panel members include Alan Kirkland, CEO of CHOICE, Conjoint Professor Anne Duggan, Chief Medical Officer for the Australian Commission on Safety and Quality in Health Care and Ms Richelle McCausland, National Health Practitioner Ombudsman. 

‘The cosmetic surgery industry has changed enormously since the current regulatory framework was introduced, with procedures now promoted through Instagram and TikTok and available in shopping centres across the country. I’m keen to explore whether consumers are being adequately informed about the risks of some procedures and whether the regulators have the powers they need to prevent harm,’ Mr Kirkland said. 

‘This review is coming at a critical time to ensure there is greater accountability in the regulation of cosmetic surgery in Australia,’ Ms McCausland said. 

‘It has been alarming to hear patients and practitioners sharing concerns about patient safety in this industry. My office regularly sees the critical role that the notifications process plays in alerting Ahpra and the National Boards of potential risks to patient safety. We need to understand how best to reduce or eliminate barriers to people sharing concerns. My hope is that this review will give us insight into how regulatory processes can keep pace with changes in the cosmetic surgery industry to best protect the public,' she said. 

Scope of the review

The review will inquire and report on: 

1. The regulatory role of Ahpra and relevant National Boards in cosmetic surgery with particular attention to its risk-based approach focusing on:  
   1. updates to codes of conduct and supporting guidance which aim to ensure that practitioners practise safely within the scope of their qualifications, training and experience
   2. the methodology for risk assessment of cosmetic surgery notifications
   3. the Ahpra investigation protocol 
   4. the management of advertising offences, and
   5. opportunities for changes, clarifications or further actions in relation to the current regulatory approach to protected titles. 
2. The way Ahpra works with other system regulators to ensure clear roles and responsibilities and appropriate information flows in support of the broader regulatory framework which involves a range of state, territory and national regulators. 
3. The best means available to strengthen the safety reporting culture within cosmetic surgery to address barriers to health professionals raising concerns when a practitioner has practised in ways that depart from accepted professional standards.
4. Strategies relevant to the role of Ahpra and National Boards as a regulator of the registered health professions to reduce information asymmetry for consumers in order to inform safer choices and informed consent. 
5. Provide a contemporary view of current risks to patient safety in cosmetic surgery and how they should inform the work of Ahpra and relevant National Boards. 

For the purpose of making its recommendations, the review is requested to consider approaches adopted by professional regulators in other countries. 

The primary focus will be on cosmetic surgery because that poses the greatest risk. However, the recommendations of this review may be relevant to the work of Ahpra and relevant National Boards in the cosmetics sector more widely. 

Public consultation will begin in early 2022.

Read the full Terms of Reference here (PDF, 32KB).

Contact us

• For media enquiries: (03) 8708 9200 
• Lodge and online enquiry form. 
• Anyone with concerns about the care they have received from a registered health practitioner, can make a notification here or by calling  Ahpra on 1300 419 495.