Stakeholder attitudes to the occupational regulation of non-registered health professions in Australia: a systematic review

Occupational regulation is a key governance mechanism through which governments seek to assure public safety, professional standards, and workforce quality. Despite ongoing debates regarding the regulation of the non-registered healthcare workforce, stakeholder attitudes toward statutory regulation of these workforce cadres have not previously been systematically examined in Australia. A systematic review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42022344660). Nine bibliographic databases and Google Scholar were searched for empirical studies published between 2000 and 2026 examining stakeholder attitudes to the regulation of fifteen non-registered health professions in Australia. Quantitative findings were summarised descriptively and qualitative findings were thematically analysed and narratively synthesised. Twenty-seven studies met the inclusion criteria examining six of the fifteen professions included in this review and representing seven stakeholder groups: consumers, practitioners of non-registered health professions, other healthcare providers (GPs and pharmacists), student practitioners, pharmacy assistants, educators, and professional association representatives. Support for statutory registration was generally strong across stakeholder groups, with support ranging from 36.0% to 94.6% (median 73.0%) and opposition ranging from 2.0% to 36.0% (median 11.0%). Stakeholders commonly justified statutory registration in terms of protecting patients and consumers, improving education and practice standards, elevating professional standing, protecting professional titles, and promoting integration in the health system. Perceived benefits of statutory registration were considered to include improved complaint handling, greater professional legitimacy, and expanded employment opportunities. Concerns regarding registration focused primarily on financial burdens for practitioners and consumers, threats to practitioner autonomy and practice philosophies, and increased accountability requirements. The evidence located in the published literature was uneven, with most studies examining naturopathy, Western herbal medicine, and paramedicine. Studies investigating the attitudes of consumers, educators, and professional associations were underrepresented in the literature and notably absent were the views of consumer advocates and policymakers. Stakeholder attitudes toward the regulation of non-registered health professions in Australia generally favour statutory registration. However, important evidence gaps remain regarding the views of policymakers and consumer advocates, and there is an absence of perspectives regarding the regulation of many non-registered health professions. Future research should examine how underrepresented stakeholder groups, particularly policymakers and consumer advocates, interpret regulatory risk, public protection, workforce quality, and regulatory effectiveness. Strengthening the evidence base in these areas may assist policymakers in developing appropriate and evidence-informed regulatory mechanisms for the non-registered health workforce and support effective health system governance. CRD42022344660.