College Affairs 2.  Australian Institute of Health and Welfare 2018. Mental health services – in brief 2018. Cat. no. HSE 211. Canberra: AIHW. https://www.aihw.gov.au/get media/0e102c2f-694b-4949-84fb-e5db1c941a58/ aihw-hse-211.pdf.aspx?inline=true 3. RANZCP Position Statement 84: Acknowledging and learning from past mental health practices https://www. ranzcp.org/news-policy/policy-and-advocacy/position-

statements/acknowledging-and-learning-from-pastmental-health

policy-and-advocacy/position-statements/recoveryand-the-psychiatrist

4. RANZCP Position Statement 76: Supporting carers in the mental health system https://www.ranzcp.org/newspolicy/policy-and-advocacy/position-statements/ supporting-carers-in-the-mental-health-system

6. RANZCP Position Statement 85: the contribution to practice made by psychiatrists who have a personal experience of mental illness https://www.ranzcp. org/news-policy/policy-and-advocacy/position-statements/the-contribution-to-practice-made-by-psychiatrists

5. RANZCP Position Statement 86: Recovery and the role of the psychiatrist https://www.ranzcp.org/news-policy/

Qualified Privilege Q & A Peer Review Groups (PRGs) have been a cornerstone of the RANZCP Continuing Professional Development Program since the 1980s. Members use PRGs to discuss cases, management and issues in a supportive and safe environment. For many years, RANZCP Peer Review Group meetings have been formally declared as an activity which has the protection of qualified privilege. What is qualified privilege? Qualified privilege provides immunity to a legal action for acts or statements that are made in the performance of a legal or moral duty. In this case the legal or moral duty is the critical appraisal of the delivery of health care services. Examples of these types of critical appraisals include mortality and morbidity meetings, critical incident reviews, root cause analyses and any other critical review of one’s practice. Health professionals may have concerns that participating in this type of critical review of their practice may leave them open to legal action and may be reluctant to fully engage. The protection of qualified privilege is a means of encouraging full and frank participation, in the interests of improving health care. What does this mean to you in your PRG? It means that information that might identify a person cannot be disclosed outside the PRG meeting, nor can a record be made of that information. In Australia disclosing identifying information or making a record that includes identifying information is a

criminal offence that can have a penalty of imprisonment. What are the laws governing qualified privilege in New Zealand and Australia? In New Zealand qualified privilege is governed by the Quality Assurance Activities (QAA) provisions of the Health Practitioner Competence Assurance Act (HPCAA). In Australia there are provisions in state and Commonwealth law. The RANZCP has qualified privilege under the Commonwealth Qualified Privilege Scheme (QPS) which is governed by Part VC of the Health Insurance Act 1973. Hospital mortality and morbidity meetings are usually protected by the relevant state law. What should and should not be disclosed under qualified privilege? In practical terms, any notes, or records of a PRG should not include any detail that might identify a patient. It is against the law to document in a patient’s clinical record that you have consulted with your PRG colleagues regarding an individual patient and that they agree (or not) with your treatment plan. This action identifies your colleagues and your patient to other health professionals who may have permission to access that record. If you need a formal second opinion, arrange for another psychiatrist to conduct an independent assessment of the patient. The usual conventions regarding patient consent apply to PRGs. If the patient is not identifiable, their case

can be discussed within the PRG. Bringing a patient file and passing it around to your colleagues is not permissible without first gaining the patient’s consent to you sharing their file with others. What does the RANZCP have to do to maintain qualified privilege for PRGs? The RANZCP must provide information annually to the New Zealand Ministry of Health and the Australian Department of Health about the activity of PRGs, specifically, how they influence the quality of health care service. PRG coordinators complete a survey that collects data on how their PRG operates, what issues have been raised within the PRG, and what actions have been taken. While individual PRGs may feel that they are not able to influence the improvement of the health care system, data collected from all PRGs over time can give a picture of many smaller actions that collectively make a difference to the way health care is delivered. Where can I find out more about qualified privilege? The legislative instrument protecting Australian PRGs: www.legislation.gov.au/Details/F2020L00609 The Commonwealth QPS operating in Australia: www1.health.gov.au/internet/ main/publishing.nsf/Content/qps-info QAA provisions of the HPCAA: www. health.govt.nz/our-work/regulationhealth-and-disability-system/healthpractitioners-competence-assurance-act/ quality-assurance-activities-under-act 613