Rethinking the national quality framework: Improving the quality and safety of alcohol and other drug treatment in Australia

The national quality framework (NQF) has been implemented to improve the safety and quality of alcohol and other drug (AOD) treatment and provide a nationally consistent approach to treatment quality in Australia. At the same time, concerns have been raised that, in the absence of appropriate regulatory structures to support the NQF, the quality and safety of AOD treatment services cannot be guaranteed in Australia. An effective enforcement strategy is critical to the ability of the NQF to provide a nationally consistent approach to the delivery of AOD treatment in Australia. The monitoring and enforcement strategy proposed by the NQF encompasses two different mechanisms. For specialist AOD treatment providers in receipt of government funding, monitoring and enforcement of the NQF will occur via contractual arrangements. For providers not in receipt of government funding, monitoring and enforcement will be managed by regulatory mechanisms as decided by each jurisdiction. This proposed enforcement strategy raises the question of whether contractual arrangements are the most effective mechanism for monitoring and enforcing the NQF in publicly funded specialist AOD treatment providers. This paper considers whether a licensing regime may address the shortcomings that arise from the proposed strategy. It argues that the pluralistic approach to the monitoring and enforcement of the NQF will result in substantive differences in how the NQF is enforced both within individual jurisdictions and on a broader national level. A licensing regime, therefore, would be a more appropriate monitoring and enforcement strategy.