Policy, politics and power in health practitioner regulation: Perspectives and experiences of healthcare stakeholders regarding the occupational regulation of non-registered health professions
- Publication Type:
- Thesis
- Issue Date:
- 2025
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𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: This research examines the perspectives and experiences of healthcare stakeholders: consumer advocates, government health policy officers, and professional body representatives, regarding the occupational regulation of fifteen health professions not registered under Australia’s Health Practitioner Regulation National Law as of 1 July 2012.
𝗧𝗵𝗲𝗼𝗿𝘆 𝗮𝗻𝗱 𝗺𝗲𝘁𝗵𝗼𝗱𝘀: A qualitative research design was employed comprising four phases: analysis of the policies and decisions leading to the National Law and the regulation arrangements governing non-registered professions; analysis of 560 documents identifying stakeholder positions and perspectives of occupational regulation; analysis of 42 interviews with 46 key informants to ascertain stakeholder perspectives and experiences of regulation; and analysis and interpretation of stakeholder perspectives using the theoretical concepts of Pierre Bourdieu within a critical realist meta-theory.
𝗥𝗲𝘀𝘂𝗹𝘁𝘀: The statutory registration scheme giving effect to the National Law was considered to promote consumer trust and confidence in practitioners, assure quality and competence, uphold professional integrity, and elevate professional standing. While most respondents perceived further regulatory measures necessary for certain non-registered professions, there was no consistent view on what those measures should be or for which professions. Respondents drew on concepts such as registration costs, decision-making complexity, practitioner qualifications, evidence-based practice, and professional disunity to argue for or against registration. A Bourdieusian analysis offers insights into the motives and methods used by stakeholders to support their views on health practitioner regulation. The findings and interpretation support the premise of this thesis that health practitioner regulation in Australia operates as a Bourdieusian field of conflict and contests between field occupants. Stakeholders used their position and power to argue for regulation arrangements according to their views, summoning Bourdieusian capitals to support their arguments.
𝗗𝗶𝘀𝗰𝘂𝘀𝘀𝗶𝗼𝗻 𝗮𝗻𝗱 𝗰𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: Findings reveal that while the policies, processes, and criteria exist to facilitate objective assessments of professions for statutory registration, the primary influence informing stakeholder perspectives is the politics surrounding health practitioner regulation. For health practitioner regulation policy to meet the needs of health consumers, reforms are needed to minimise the subjective nature of policy decision-making and limit the ability of social actors to influence policy outcomes for reasons inconsistent with the assessment criteria. To maintain consumer safety, it is the responsibility of governments to proactively assess non-registered health professions to ensure appropriate regulatory settings are in place. This is a responsibility in keeping with Australian health policy regulatory stewardship principles and the public protection paramount guiding principle of the Health Practitioner Regulation National Law.
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