Annual report 2020-21

Learn more about how we achieved fair and positive change in the regulation of registered health practitioners in 2020-21

Read the annual report now (PDF)

Our year in numbers
Our work this financial year
received approaches
complaints to the Ombudsman received
enquiries received
FOI matters received

Ombudsman and Commissioner's message

The coronavirus (COVID-19) pandemic continued to have a profound effect on our professional and personal lives this financial year. Australia’s health sector is at the centre of the pandemic response, and our community has rightly praised the extraordinary work of registered health practitioners who went above and beyond to provide essential services.

In response to the challenging circumstances raised by the pandemic, my office prioritised the safety of our communities and the wellbeing of our staff. We focused on providing a continuous, high-quality and empathetic complaint-handling service while also supporting our staff who worked from home for most of the year.

Despite the challenging circumstances, I am proud that my office has continued to champion fairness and bring about significant changes in the National Registration and Accreditation Scheme. Highlights from this financial year included:

  • working with the Australian Health Practitioner Regulation Agency (Ahpra) and the National Health Practitioner Boards to resolve individual concerns and make systemic improvements (examples of significant improvements are found in the case studies throughout this annual report)
  • beginning my office’s review of accreditation processes, including engaging with the many accreditation entities to understand existing complaint and appeal processes, prior to my office undertaking our new role in handling complaints about accreditation entities
  • launching our new website to make our office more accessible to health practitioners and the public.

It is a privilege to have been reappointed Ombudsman and Commissioner for a second term. It has been deeply rewarding to guide my office through a transformative three years, and I look forward to working with my team to deliver on our full potential over the next three years.

During the pandemic, I put this quote from Mark Twain above my computer: ‘Continuous improvement is better than delayed perfection’. This idea underpins my office’s approach to all aspects of our work.

I thank all of those who have worked alongside me and my office to strive for continuous improvement in the National Scheme.


Richelle McCausland

National Health Practitioner Ombudsman

National Health Practitioner Privacy Commissioner


Read our annual report (PDF)

Complaints to the Ombudsman
Our work related to complaints to the Ombudsman
complaints received
complaints finalised
investigations finalised
complaint transfers

Complaints to the Ombudsman

In 2020–21 our office received 580 complaints to the Ombudsman. These complaints were made by 393 individuals, some of whom made multiple complaints to us over the course of 2020–21.

The Ombudsman can consider complaints that relate to how a matter was handled, not whether Ahpra or a Board’s decision about a matter was right or wrong.

In 2020–21 we mainly assisted with complaints about how Ahpra and the Boards handled a notification (59 per cent) or a registration-related matter (34 per cent). 

Common complaint issues

We identified 1,071 issues across the 580 complaints we received in 2020–21.

As expected, most complaint issues related to the notification (47 per cent) and registration (27 per cent) complaint types. Issues associated with customer service were also frequently raised (17 per cent).

For example, delay in managing a notification or registration matter is a frequent issue raised with our office. In several cases, when Ahpra was made aware of the delay as part of our office’s early resolution transfer process, the complainant was offered an apology and was connected with Ahpra staff to discuss and progress their matter.

While delay continues to be a problem that needs improving, there are two significant changes this financial year that could reduce delay in the future:

  • a new framework for efficiently dealing with low-risk notifications
  • potential amendments to the Health Practitioner Regulation National Law (the National Law) currently being considered by health ministers, which may result in reducing the time it takes to finalise notifications.

Our office continues to monitor concerns about Ahpra’s timeliness and to identify areas where improvements to processes may reduce delay. We have also suggested improvements to Ahpra about the need to outline realistic expectations for managing matters when revising its service charter.

Who complaints were about and where they came from

As in previous years, most complaints to our office were about the regulation of the medical, nursing/midwifery and psychology professions.

All complaints we received involve Ahpra in some way because Ahpra is the main point of contact for people interacting with the National Scheme.

As in previous years, most complaints to our office came from people located in Victoria. This trend is likely due to the large number of registered health practitioners who are part of the National Scheme in Victoria.

Early resolution of complaints
We aim to resolve complaints in an efficient and effective way
preliminary inquiries made
complaints transferred to Ahpra
complaints finalised at the assessment stage
complaints finalised through the early resolution transfer process with Ahpra


We recorded 626 outcomes across the 544 complaints our office finalised this financial year.

Early resolution transfer process

In 2020–21 we assessed 166 responses that Ahpra provided through the early resolution transfer process. Most of these complaints were finalised without further inquiries or investigation from us (104, 63 per cent).

The most common outcome of complaints finalised at the early resolution transfer stage was our office deciding Ahpra’s response to the complaint was fair and reasonable (45).

Investigation outcomes

We finalised 118 complaints following an investigation during 2020–21. All but 10 of these complaints related to a notification matter (108, 92 per cent).

We recorded 149 outcomes across these 118 complaints. Most investigations resulted in our office providing a further explanation to the complainant (98 outcomes), followed by the Ombudsman providing formal comments or suggestions for improvement to Ahpra (11 outcomes).

Providing a further explanation to the complainant

The most common investigation outcome was providing a further explanation to the complainant about the decision or action they complained about (98). This means we did not identify a major error in how Ahpra or the relevant Board handled the complainant’s matter. Instead, we helped the complainant to better understand how their matter had been handled. This is a consistent trend in our complaints data.

Commissioner complaints

Our office accepts complaints to the Commissioner about the handling of personal information by Ahpra and the Boards. Ahpra and the Boards keep records that may contain personal information.

When we receive a complaint about the handling of personal information, the Commissioner can decide:

  • what action should be taken to resolve a complaint
  • whether compensation should be awarded for any loss or damage suffered due to a breach of privacy
  • that the handling of personal information was reasonable and take no further action.

The Commissioner’s power to consider privacy complaints comes from the Privacy Act, which has been modified by the National Law.

This financial year, our office received privacy-related complaints from three different people. We have historically received very few privacy complaints, including only one complaint in 2019–20.

Our office finalised one complaint made to the Commissioner this financial year after making preliminary inquiries into the release of another person’s personal information to the complainant.

Notifiable Data Breaches Scheme

Ahpra and the Boards must notify our office about data breaches involving personal information that are likely to result in serious harm. A data breach of this nature is called a ‘notifiable data breach’.

Although notification is not formally required for breaches assessed to be unlikely to result in serious harm to those affected, the Commissioner welcomes voluntary disclosure of any data breaches by Ahpra and the Boards.

This financial year we received one eligible notification from Ahpra about a data breach. This is the first eligible notifiable data breach we have received since our role in the Notifiable Data Breaches Scheme began on 22 February 2019.

Freedom of information matters
Freedom of information review applications
FOI review applications received
FOI review applications finalised
FOI reviews started
FOI review decisions published

Freedom of information matters

By law, everyone has the right to request access to information held by Ahpra, its Management Committee and the Boards.

For the past two years, our office has had the power to review Ahpra’s FOI decisions.

This financial year we received 16 applications to review a decision made by Ahpra under the Commissioner’s FOI powers. This is a small decrease in the number of applications compared with the previous financial year (20).

Freedom of information review applications

Ahpra received 204 FOI applications this financial year and 13 applications for an internal review of a decision. We received nine applications to review an access refusal decision and seven to review an internal review decision. It therefore appears that applicants who had already requested an internal review from Ahpra regarding its original FOI decision were more likely to request a review from our office as well.

Applicants most frequently sought documents from Ahpra regarding notifications made about health practitioners. This included the practitioners’ responses to notifications (7) and Board papers that informed the Boards’ decisions about notifications (including assessment reports, investigation reports and attachments) (17).

A plan to champion fairness

Our 2020 to 2023 strategic plan outlines how we strive for positive change in the regulation of Australia’s registered health practitioners. Our plan to champion fairness has four strategic directions.

  1. Influencing systemic improvements
  2. Engaging and communicating
  3. Building capacity
  4. Enhancing accountability

Find out more about our strategic directions

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