Health Professionals Crossing Borders Torben Hærslev, MD

Danish Health Personnel Authorisation 16 groups of authorised health personnel Authorisation given by DHMA Full licence annulled at 75 without re-application All authorised groups under the Health Personnel Act All under the supervision of DHMA 02-12-2018

Based on incidence reports Supervision from 1934-2000 Based on incidence reports Evaluation of whether the health personnel have displayed care and conscience Limitation of the prescription right (1956) Reprimand or acquittal by the courts or the complaint system Revocation of authorisation only due to illness, abuse or severe malpractice (danger for patients) 1.1.1956 Fratagelse af ordinationsret

Changed Legislation in 2000 Mandatory change of professional performance, when repeated malpractice is proven by the Patient complaints board or the courts. Limitation in authorisation or loss of authorisation, if the sanction is not complied with Weakness: DHMA had to await the decisions of others before we could act – very time consuming

Another change in 2006 Intensified surveillance When there is reason to believe that the health person's practice is a safety risk for the patients Publication of all sanctions on the web site

The latest change of enactment 2011: No longer any need to wait for decisions from other agencies or the courts 2013: Temporary revoking or limitations to the authorisation if the health person does not cooperate with the DHMA

Volume Before 2005: 1-2 revoked authorisations/year 2012/2013: 17 voluntary renouncement's 7 work bans 12 prescription limitations

Sanctions in Danish legislation Intensified surveillance Mandatory change of professional conduct Limitations in prescription or fully revoked Limitations in authorisation or fully revoked Work ban Injunction to comply with medical examination

Arrival and departure Going out Coming in Certificate of current professional standing When an authorised health person applies for a licence in another country We always write all current or recent sanctions We do not inform about: Health issues On-going not resolved cases CCPS If issues then contact to other supervisory organisation We only refuse, if the issues would cause loss of authorisation in Denmark Immediate sanctions can be relevant

Exchange of information According to a Nordic agreement we exchange the following with the Nordic countries Revokements and renouncements Limitations We have a register available to all on our web Other information is given on request to all countries Health information only by consent 02-12-2018

Problem areas When a Health Person (HP) all ready authorised in several countries, gets sanctioned – how do we know? Can we within our legislation use the sanctions of other countries? How do we keep track of the HP who always leave, when the going gets though?

Thank you!