Greater Protections Against Assaults and Violence for Private Practice
Doctors in private practice finally receive the same protections as the rest of the profession.
WHEN THE NSW PARLIAMENT passed legislation providing greater protections for frontline workers in October 2022 the Australian Medical Association (NSW) commended the change. GP, Dr Michael Bonning was AMA (NSW) President at the time.
“Improved safety for frontline workers is something the AMA has championed for many years. The need for greater protections became more urgent and more obvious during the Covid pandemic.”
DR MICHAEL BONNING
“While we welcomed the change, right from the first reading in June 2022, we were disappointed. The legislation covered first responders, public health workers, National Parks and Wildlife officers and pharmacy staff. What it didn’t include were doctors in private practice and their staff. So, GPs, other private specialists, practice nurses, receptionists and
other administrative staff, - all excluded from the legislation.”
“I think doctors felt it was quite a snub because when it comes to patient assaults, they’re the ones who you hear about so often. There have been several high-profile cases of doctors being assaulted in their practice rooms, not only in NSW. There was an assault on a GP in South Australia and terrible cases of community doctors and private specialists in Victoria being attacked and a horrendous one in Tasmania.”
Dr Bonning said.
AMA (NSW) approached NSW Health to ask why the legislation
In early 2023 AMA (NSW) surveyed all its private practice members.
The Crimes Legislation Amendment (Assaults on Frontline Emergency and Health Workers) Bill 2022 introduced penalties from 12 months to 14 years for offences including:
• Hinder or obstruct;
• Incite another person to hinder or obstruct;
• Assault, throw a missile at, stalk, harass or intimidate;
• Wound or cause grievous bodily harm to;
• Be reckless as to cause actual bodily harm to; a frontline emergency or health worker in the course of the worker’s duty.
excluded doctors in private practice and their staff. The answer – there wasn’t information to understand the scope of the issue in private practice. They had the data on hospital doctors but they didn’t have the data on private practice so private practices weren’t included.
Dr Bonning, as AMA President wrote to then Health Minister Brad Hazzard who indicated that there was not evidence to justify extending the new laws but did refer the matter to the then Attorney General. “So, we set about finding the data. We surveyed all our private practice members. The results sadly underlined our concerns.”
Of 378 medical practices in NSW 88% reported experiencing verbal aggression from a patient such as swearing or shouting, while 37% reported experiencing physical aggression including slapping, scratching, spitting and punching of doctors and medical staff. Some staff required medical treatment after patient assaults.
We conveyed the results to the Minister and the department, along with the results of the Medicine in
Australia: Balancing Employment and Life longitudinal survey conducted between 2010 - 2011 of almost 10,000 Australian doctors, which found 70.6% reported experiencing verbal or written aggression, and 32.2% reported experiencing physical aggression in their previous 12 months of practice. GPs reported slightly lower rates than hospital colleagues in that survey, but incidents were still high – 54.9% verbal aggression, 23.4% physical aggression. Along with private communications we made sure the issue was raised and remained in the eye of the public through mainstream and social media.
“I kept talking to journalists, I kept posting about it and doctor colleagues and others continued to repost the message.” Dr Bonning said.
“I was trying to get lawmakers to understand what it’s like for doctors. There is something inherently unsafe about being in a consulting room, just you and one other person. In your consulting room, if something goes wrong, it’s you and them. And that can be pretty scary.” Dr Bonning said.
Dr Bonning related an experience he had while working at a private medical practice. A 40-yearold man walked in late at night demanding medication.
“The prescription he wanted was for an opioid medication –something we wouldn’t lightly prescribe and certainly would never prescribe on the first consultation
FEATURE
Of 378 medical practices in NSW 88% reported experiencing verbal aggression from a patient such as swearing or shouting, while 37% reported experiencing physical aggression.
with a new patient.” When during the consultation Dr Bonning questioned the patient, the man became agitated before coiling up and lunging to take a swing at him.
“I’m six foot five, 100 kilos – I’m not a small person and not usually intimidated by many things, but to feel scared in your own place of work – to feel like there is a real risk of harm to yourself is just horrible, like your heart is beating out of your own throat.”
“And it’s not just the physical abuse. It’s the verbal abuse, which became relentless during the Covid pandemic and sadly has remained at an inappropriate level.”
When there was a change of government in March 2023 Dr Bonning made it a priority to raise the issue in his first meeting with new Health Minister Ryan Park.
“I was like, ‘Look, this is a place where the government can do something meaningful to connect the entire clinical community so that everyone has the same protections, recognising that we are all one team.”
“I outlined all of the issues we had been campaigning on and I think it carried a lot of weight with the minister. He understood, and we had data to back it up. We had a cohesive story to tell, and he could see that it was an important one.”
In passing the amendment Minister Park said, “I want to thank the NSW Australian Medical Association for their advocacy for this change, especially Dr Michael Bonning.”
Late on the evening of May 9th the NSW Parliament passed the Amendment of Crimes Act 1900 No 40 2024 as part of the Health Legislation Amendment (Miscellaneous) Bill 2024. The amendment expands the definition of frontline workers to include doctors, nurses, reception staff and other health workers employed in private practice.
“It is unfortunate these added protections are necessary, but we are grateful for them.” Dr Bonning said.
“On behalf of the doctors and their staff in NSW we thank Minister Park and the NSW Parliament.
“Legislative change is not easy. It takes policy, data, networking, lobbying and relentless advocacy.
I am very proud of all the doctors and the team at AMA (NSW) who stood behind and carried this campaign.” Dr Bonning added. “AMA (NSW) hopes this new legislation will further discourage what is a minority of patients from abusing, harassing or, in the worst cases, assaulting the hard-working private sector doctors of this state”. dr.