The CEO of the Australian Health Practitioner Regulation Agency (Ahpra), Justin Untersteiner, appeared before the Royal Commission into Antisemitism and Social Cohesion this week, and explained why the regulator changed its view on using a controversial definition of antisemitism, reports Jason Staines.
Jason Staines writes:
Australia’s health regulator has provided its clearest explanation yet of why it adopted the International Holocaust Remembrance Alliance (IHRA) Working Definition of Antisemitism, telling the Royal Commission into Antisemitism and Social Cohesion it initially resisted the move because of concerns it could inhibit legitimate free speech within the health system.
Appearing before the Commission this week, Australian Health Practitioner Regulation Agency (Ahpra) CEO Justin Untersteiner said the regulator had delayed adopting the definition because it was concerned it could stifle free speech within the health system.
He said Ahpra changed its position after publication of the Special Envoy to Combat Antisemitism’s handbook, which provided greater clarity about how the definition should be understood and applied.
“We had not yet adopted a definition. We had resisted that for a period, and we had done that on the basis that we were certainly hearing some concerns about the risk of the IHRA definition stifling free speech, legitimate free speech … in the health system,” Untersteiner told the Royal Commission.
“Very helpfully, I believe, it was in April this year, the Australian Special Envy Combatting Anti-Semitism released a new handbook. And the handbook … provided greater granularity and detail about the definition, about what it does mean and what it doesn’t mean. And some examples include, it’s very clear that the criticism of [the] Israel Government, for instance, do not constitute anti-Semitism, and that’s often where there has been criticisms in the past.”
The evidence came days after Ahpra released the findings of a review into almost 500 notifications involving racism and discrimination, which found social media has become the dominant setting for complaints involving alleged antisemitism and Islamophobia while also identifying opportunities to improve the way low-risk matters are handled.
Why Ahpra changed course
Ahpra’s review examined 477 notifications relating to racism and discrimination received between July 2023 and February 2026 – around 1.5 percent of all notifications during the period. It concluded that racism and discrimination complaints are becoming increasingly complex, driven by broader social and geopolitical events and the growing role of online platforms.
The review found that 44 percent of notifications involved practitioner conduct on social media. Among complaints involving alleged antisemitism and Islamophobia, that figure rose to around 80–85 percent. Notifications concerning other forms of racism and discrimination were more likely to arise from conduct in clinical settings.
Croakey previously reported on Ahpra’s adoption of the IHRA definition and the concerns it prompted among some health organisations about potential implications for freedom of expression and advocacy for the health and human rights of Palestinians. The Royal Commission evidence sheds new light on the regulator’s decision-making.
At the Royal Commission, Untersteiner said the increase in complaints prompted Ahpra to strengthen its approach through specialist training, the establishment of a dedicated racism and discrimination team, and closer engagement with affected communities. However, he said the regulator initially resisted adopting the IHRA definition because consultation had highlighted concerns it could inhibit legitimate free speech within the health system.
He told the Commission that Ahpra continued discussing those concerns with community organisations and the Special Envoy to Combat Antisemitism before the publication of the envoy’s handbook earlier this year.
Untersteiner said the handbook provided greater certainty about what the definition does – and does not – mean, including making clear that criticism of the Israeli Government does not, of itself, constitute antisemitism and that the definition is intended as a reference tool rather than part of Australian law.
He said that additional guidance, together with the feedback Ahpra had received during consultation, gave the regulator confidence to adopt the definition.
Key question
A key question raised by health and legal experts following Ahpra’s adoption of the IHRA definition has been where the line sits between legitimate professional advocacy and conduct that warrants regulatory action.
The review emphasises that adopting the IHRA definition does not alter practitioners’ existing professional obligations. It states that Ahpra remains committed to freedom of expression and to the right of practitioners to participate in professional and public debate. Regulatory action may arise, however, where commentary becomes demeaning or discriminatory or is directed at members of a particular community.
Untersteiner reinforced that message before the Royal Commission, saying criticism of the Israeli Government would not, in itself, constitute antisemitism, but that discriminatory conduct could attract regulatory scrutiny.
Untersteiner said practitioners could “very rarely” separate their private and professional identities on social media because “there is a special level of trust that is placed in a health practitioner in a health system”.
He also sought to reassure practitioners concerned that the adoption of the definition might restrict discussion of international conflicts.
He told the Commission that Ahpra recognised health practitioners’ right to express views on political and other public issues, including through social media, and would not take regulatory action simply because a practitioner commented on an international conflict. Rather, the regulator’s concern was where commentary crossed the line into racism or discrimination directed at an individual or group.
“This can be misconstrued in that, for instance, Ahpra adopting the IHRA definition means that people are no longer able to express their views about international conflicts. And again, that is not true. We will not get in the way, or we will not take a regulatory action, for doing that, as long as it’s done respectfully and accurately. But again, as soon as that veers into discrimination or racism … you certainly have the attention of us as a regulator,” he said.
Improving the process
While the review concludes that Ahpra and the National Boards have generally applied appropriate and proportionate regulatory thresholds, it also contains a series of candid observations about how the notifications process can be improved.
It found communication with practitioners should occur more quickly to reduce distress, that some matters involving little apparent risk to public safety nevertheless proceeded through full regulatory assessment, and that outcome letters sometimes provided insufficient reassurance when concerns proved unfounded.
The review also recommends earlier and more consistent use of Ahpra’s Vexatious Notifications Framework after identifying variation in how it was applied.
Those findings echo concerns raised by several medical organisations following the adoption of the IHRA definition, including worries that even complaints ultimately dismissed can impose considerable stress on practitioners.
Elaborating before the Commission, Untersteiner acknowledged the review had identified cases where relatively low-risk complaints progressed further through the regulatory process than they should have, creating unnecessary stress for practitioners.
He also said the review found examples where further investigation may have been warranted, reinforcing the need for more consistent application of Ahpra’s assessment frameworks rather than simply reducing the number of investigations.
He said the regulator also intended to strengthen application of its Vexatious Notifications Framework. While only one complaint in the review period met the legal threshold to be declared vexatious, Untersteiner said Ahpra believed there had been cases where “there would have been merit in further investigation and assessment about whether a complaint was vexatious or not”. He said the response would involve both improved staff training and reviewing the framework itself “to make sure it’s fit for purpose.”
Ahpra says it has already reduced the average time taken to finalise notifications involving racism and discrimination from 132 days to 53 days and plans to publish six-monthly performance data as further reforms are implemented.
The review also provides the clearest picture yet of how these matters are resolved.
Of 439 notifications finalised by February this year, 406 resulted in no regulatory action, while 28 resulted in restrictions, conditions, cautions or other regulatory outcomes. Four practitioners were referred to tribunals.
The report cautions against interpreting the absence of regulatory action as meaning concerns were baseless. Some practitioners undertook education voluntarily, some matters had already been dealt with by employers or health complaints bodies, while others were not substantiated.
The review also notes that concerns about racism and discrimination are likely to be under-reported, particularly by Aboriginal and Torres Strait Islander peoples, meaning notification data should not be regarded as a measure of the prevalence of racism in healthcare.
Ethical responsibility
The Royal Commission hearing took place against the backdrop of continuing conflict in Gaza and Lebanon, which continues to generate intense concern within the international health community.
Reporting by The Guardian this week documented the experiences of Lebanese surgeons and paramedics working during the Israel–Lebanon conflict, including accounts of colleagues killed while responding to emergencies and healthcare workers living for months inside hospitals because they considered it too dangerous to return home.
Lebanon “has become one of the world’s deadliest places for healthcare workers, with Israel targeting doctors, first responders and healthcare facilities with alarming regularity”, The Guardian reported.
For many Australian practitioners, such reporting reinforces why they regard speaking publicly about humanitarian crises and attacks on healthcare workers as a professional and ethical responsibility.
The review sets out six actions to be completed by the end of this year, including strengthening guidance for staff, improving communication with practitioners, refining risk assessment processes, strengthening the Vexatious Notifications Framework, adopting additional reference definitions – including a definition of Islamophobia – and improving data sharing across the health system.
Whether those reforms are sufficient to reassure practitioners who remain concerned about the implications of Ahpra adopting the IHRA definition remains the focus of ongoing negotiations and advocacy from across the health sector.
Previously at Croakey
- Ahpra faces growing concern over its support for contested definition of antisemitism
- Ahpra support for contested definition of antisemitism is slammed as divisive and harmful
See Croakey’s archive of articles on health regulation
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