The respondent admitted overall that she behaved in a way that constitutes professional misconduct. The parties made a joint submission as to the disciplinary action that ought to be imposed.

• Having regard to the fact that some education was completed after the 2017 conditions were imposed and that compliance was then made difficult or impossible by extraneous circumstances, the failure to comply with the 2017 conditions constitutes unprofessional conduct.
• In respect of the failure to comply with mentoring conditions set in the 2019 conditions, the practitioner could have acted in a timelier way and more effectively to ensure that the required mentoring was put in place. However, the Board also contributed to delay and the events all occurred against a background of disruption due to the pandemic. No finding of misconduct is made in relation to this allegation.
• In respect of the failure to comply with supervision conditions set in the 2019 conditions, the practitioner's conduct in deliberately and persistently contravening the conditions was extremely serious and constitutes professional misconduct.
• In respect of the failure to keep adequate patient records, the respondent's conduct constitutes professional misconduct. The Board had already cautioned the practitioner in 2017, identified this area as requiring attention and imposed conditions requiring education in this very area yet the respondent's records in the period from December 2019 to August 2020 was well below the required standard.
• The respondent's conduct of swearing an affidavit that contained untrue assertions was reckless as she gave no serious consideration as to whether or not the statement was true. This conduct constitutes professional misconduct.

Health practitioners - Complaint by the Dental Board of Australia - Professional misconduct and unprofessional conduct - Failures to comply with previous conditions imposed on registration, Failure to keep adequate patient records, Swearing an affidavit with untrue assertions - Registration suspended up to and including 18 September 2021, Conditions imposed on registration and are to be reviewed in 12 months, Reprimand

Health Practitioner Regulation National Law (South Australia) Act 2010 (SA) Schedule 2 ss 156, 178, 196

South Australian Civil and Administrative Tribunal Act 2013 s 60

Briginshaw v Briginshaw 1938] HCA 34; (1938) CLR 336

Rajagopalan v Medical Board of South Australia [1997] SASC 6363

Rajagopalan v Medical Board of South Australia [1998] SASC 7142

Neat Holdings Pty Ltd v Karajan Holdings Pty Ltd (1992) ALJR 170

Nursing and Midwifery Board of Australia v Hissey [2020] SACAT 80

Prakash v HCCC [2006] NSWCA 153

Pursuant to s 60 of the South Australian Civil and Administrative Tribunal Act 2013, the Tribunal prohibits the publication of the name of, or anything tending to identify, any patient named in the proceedings or any person who made a notification under the National Law in respect of the practitioner.

1. Dr Louise Cooper is a registered dental practitioner (the practitioner). On 18 September 2020 the Dental Board of Australia (the Board) took "immediate action" under s 156 of the Health Practitioner Regulation National Law (South Australia) (the National Law)[1] to suspend her registration.

2. Matter 2020/SHP000031 is an application by the practitioner for review of that decision to suspend her registration (the review proceeding).

3. Matter 2021/SHP000007 relates to the referral of disciplinary proceedings against the practitioner under s 193 of the National Law (the disciplinary proceedings).

4. By joint request of the parties, the Tribunal has heard the disciplinary proceedings and held the review proceedings in abeyance to await the outcome. The disciplinary proceedings were heard on 11 August 2011 and decision reserved.

5. On that day, the Tribunal made a confidentiality order in respect of the identities of patients and notifiers. The terms of that order appear at the end of this Statement of Reasons.

6. In summary, it was alleged that the practitioner had:

(a) failed to comply with conditions imposed on her registration by the Board on 14 July 2017 (2017 Conditions) in that she failed to undertake education as required;

(b) failed to comply with conditions imposed on her registration by the Board on 13 December 2019 (2019 Conditions) in that she failed to partake in and complete a required mentoring program;

(c) failed to comply with the 2019 Conditions in that she performed indirect restorations on patients' teeth without required supervision;

(d) failed to keep adequate patient records for a number of identified patients.

(e) swore an affidavit for use in this Tribunal containing assertions that were untrue.

7. The parties filed a Statement of Agreed Facts. The Tribunal also had before it, documentary evidence and the parties made submissions as to certain disputed matters. We shall return to these matters later in these Reasons.

8. Overall, the practitioner admitted that she had behaved in a way that constitutes professional misconduct.

9. The parties made a joint submission as to the disciplinary action that ought to be imposed. They suggested that the practitioner should be reprimanded and that her registration should be suspended for one year. As the practitioner had already been suspended since 18 September 2020 by way of immediate action, the parties proposed that the Tribunal should suspend her until 18 September 2021. The parties also jointly suggested that conditions should be imposed on the registration of the practitioner, in order to ensure the protection of the public when the practitioner returned to practice.

10. The authorities suggest that an agreed position between the parties is a very important matter for the Tribunal to consider and an agreed position should only be departed from for a compelling reason. In this case, subject to minor modification of the proposed conditions of practice, we accept that the outcome proposed by the parties is an appropriate outcome and we will proceed accordingly. For this reason, we will deal with the facts and our approach to sanction in a reasonably brief manner.

11. We observe that the standard of proof in these proceedings is proof on the balance of probabilities, having regard to the principles explained in Briginshaw v Briginshaw.[2] We have regard to the seriousness of the allegations and the potential consequences for the practitioner. We give weight to the presumption of innocence. We take into account evidence of the practitioner's good character.

12. We make findings in accordance with the agreed facts. Our further findings will appear from what follows.

13. The 2017 Conditions were imposed on 14 July 2017 pursuant to s 178 of the National Law. After considering a notification,[3] the Board formed the view that the way in which the practitioner had practised dentistry was or may be unsatisfactory. It took action to caution the practitioner and to impose conditions on her registration.[4] The conditions required the practitioner to undertake a minimum of 24 hours of education and provide a reflective report concerning the topics of clinical assessment, diagnosis including endodontics, treatment planning, informed consent and record keeping.[5] The education was to be completed within six months of the Board giving approval to the courses.

14. By 12 July 2019 the practitioner had only completed 18.5 hours of approved education. Other courses had been approved by the Board but had not been completed. The Board decided to establish a Performance and Professional Standards Panel under s 182 of the National Law to consider an allegation that the practitioner had failed to comply with the 2017 Conditions. The practitioner attended personally and was represented at a hearing before the Panel in October 2019.

15. By decision dated 11 November 2019[6] the Panel found that the practitioner's behaviour constituted unsatisfactory professional performance. The Panel reprimanded the practitioner. The practitioner gave a verbal undertaking to ensure future compliance with the 2017 Conditions.

16. There was a window of opportunity after this decision during which the practitioner completed some education but did not fully comply with the conditions. Thereafter, the practitioner's ability to complete education has been affected by the pandemic and completely stayed by virtue of the suspension of her registration in September 2020.[7] She has now completed 24.5 hours of education. However, it was agreed in the Statement of Agreed Facts[8] that she has not completed an approved course in relation to informed consent and record keeping.

17. The Tribunal notes the reprimand imposed after the hearing in October 2019. This is relevant as an instance of previous misconduct to which we should have regard, and as the background to what has happened since. However, we do not intend to discipline the practitioner again for the same (pre-October 2019) conduct. We will discipline her for continuing the conduct after that date. In categorising the conduct, we will therefore confine ourselves to the failures continuing after October 2019.[9]

18. The Board argues that a finding of professional misconduct is appropriate. This would normally be so in the case of continuing failure following the imposition of a reprimand. However, having regard to the fact that some education was completed during this period and that compliance was then made difficult or impossible by extraneous circumstances, we are moved to judge the practitioner's failure less harshly.

19. The practitioner admits that her failure to comply with the 2017 Conditions constitutes unprofessional conduct. In all the circumstances, we agree with that categorisation.

20. The 2019 Conditions were imposed on 13 December 2019 under s 178 of the National Law. After considering a notification which related to the practitioner's performance in providing restorative treatment, namely insertion of a crown, to a patient, the Board determined that there were inadequacies in her assessment, treatment planning, record keeping and communication of risks. The Board found that the practitioner's patient records did not comply with relevant guidelines and were below accepted standards.

21. Accordingly, the Board formed a belief that the way the practitioner practised dentistry was or may be unsatisfactory and decided to impose conditions on her registration.

22. The 2019 Conditions[10] contained requirements as to supervision and mentoring. With regard to mentoring, the Conditions provided that the practitioner "must be mentored by another registered health practitioner in relation to examination, diagnosis, and treatment planning in relation to indirect restorative treatment."

23. The practitioner was required to nominate, "on the approved form", a person(s) to be approved by the Board to act as mentor. The approved form required a "mentoring plan" to be specified. This was not a requirement in the Conditions themselves.

24. On 14 January 2020 the practitioner nominated a proposed mentor. On 21 April 2020 the Board advised the practitioner that it did not approve the nominated person. On 25 May 2020 the practitioner nominated another proposed mentor. On 12 June 2020 the Board approved the proposed mentor but did not approve the proposed mentoring plan. It appears that this decision was not communicated to the practitioner until at least 3 July 2020. Guidance as to what would constitute an adequate mentoring plan was not provided to the practitioner until 16 July 2020.

25. On 19 August 2020 the practitioner submitted a revised mentoring plan. The Board rejected it as it was not prepared in the correct format. Shortly thereafter, events were overtaken by the Board action that led to suspension of the practitioner's registration.

26. We accept that the practitioner could have acted in a timelier way and more effectively to ensure that the required mentoring was put in place. However, the Board also contributed to delay. Furthermore, these events all occurred against a background of disruption due to the pandemic.

27. The practitioner contends that she was not in breach of the Conditions as to mentoring. We consider that there is some force to this argument. The Conditions require approval of a mentor but are silent as to responsibilities if approval is declined. The Conditions are silent as to approval of a mentoring plan. The approved form requires a plan to be specified but is unhelpful as to what is required. Presumably, the Board ought not to approve a mentor if not satisfied with the proposed plan. In this case, approval of the mentor was given but on the apparent basis that mentoring could not begin because the plan had not been approved. The Conditions do not provide for this occurrence at all.

28. In all of the circumstances, we do not make a finding of misconduct in respect of this allegation.

29. The 2019 Conditions provided[11] that the practitioner must not undertake indirect restorations (of a type specified by item numbers in the Australian Schedule of Dental Services and Glossary) without being supervised by an approved supervisor.

30. The conditions required that the practitioner consult with and have the approval of the supervisor before commencing any treatment.

31. The table at C1 page 76 sets out the details of 32 patients provided with treatment in contravention of the Conditions between 16 December 2019 and 1 September 2020. Some patients had multiple treatments.

32. At least 14 of those treatments were provided before the practitioner even nominated a supervisor for approval. The practitioner was notified of the approval of two supervisors on 3 July 2020. Thereafter she provided treatment to a further 14 patients without supervision. It is clear that the practitioner provided the treatments, well knowing that she was doing so in breach of the conditions. She claimed that she felt pressured to undertake the work but that is no excuse for her actions. She did not make any serious attempt to adequately engage with her approved supervisors[12] but simply continued to act in contravention of her conditions of practice.

33. The final treatment contrary to the Conditions was provided after earlier contraventions had been drawn to her attention by the Australian Health Practitioner Regulation Agency (AHPRA) and her explanation had been sought.[13]

34. The Conditions had been imposed to protect the public and ensure the maintenance of appropriate standards of treatment. Such conditions must be scrupulously observed.[14] The practitioner's conduct in deliberately and persistently contravening the Conditions was extremely serious. The practitioner admits that it was professional misconduct, and we have no hesitation in making a finding to that effect. It is conduct that was inconsistent with the practitioner being, at the time, a fit and proper person to be registered.

35. We need say little about the issue of inadequate dental records in addition to what appears in the Statement of Agreed Facts.[15]

36. The practitioner admits that the identified deficiencies amount to unprofessional conduct. That is how we may have categorised this conduct. However, the inadequate records relate to the period from December 2019 to August 2020. We must have regard to the fact that the Board cautioned the practitioner in 2017 and identified this area as requiring attention. Conditions were imposed requiring education in this very area. Yet the standard of records in 2020 was well below standard. We find that this constitutes professional misconduct. It is conduct substantially below the standard to be reasonably expected of a person of the practitioner's level of training and experience.

37. In the review proceedings, the practitioner appealed[16] against the suspension of her registration by the Board on 18 September 2020. She filed an affidavit sworn on 24 November 2020 in support of her appeal.[17]

38. In the affidavit the practitioner deposed as follows:[18]

From December 2019 to June 2020 I was not able to see any patients who required crowns. Those patients that rang Smile Co that required crowns were put off from seeing me. I didn't see any patients who required crown treatment until after my supervisors were approved. At that stage there was a significant backlog of patients who refused to see other dentists.

39. This statement (the impugned statement) was not true. From December 2019 to June 2020, she had continued to provide crown treatment to patients as previously indicated. She had done so in full knowledge that she was acting in breach of her conditions of practice.

40. Both counsel eschewed any suggestion that the practitioner was acting in a deliberately dishonest manner when she swore this affidavit. Counsel for the practitioner submitted that her actions were "utterly careless" or "unacceptably and seriously careless". Counsel for the Board submitted that she had acted recklessly, with "reckless indifference" as to whether or not the statements were true.

41. We do not accept the claim of the practitioner[19] that she had a positive belief in the truth of the impugned statement when the affidavit was sworn. We do not accept that she needed access to records or other documents to know whether or not the statement was true. We alerted counsel at the outset of the hearing to our concerns about these claims. The practitioner did not give oral evidence.

42. We note that the practitioner was well aware in June 2020 (and earlier during that year) that she was continuing to perform treatments contrary to her Conditions. So much is admitted. On 18 August 2020 an officer of AHPRA emailed her[20] concerning billing records for July 2020 which suggested that she had performed crown work without supervision. He sought her response and also queried whether she had done such work in August 2020.

43. The practitioner responded by email on 19 August 2020. She admitted doing the work in July but failed to reveal that work had been done in June and earlier in 2020 in contravention of the conditions.[21] She stated:[22]

I am under so much pressure. My workplace puts an incredible amount of pressure on us, as dentist, to do crowns and essentially Cerec crowns. Richard Sawers[23] came in to Smile co and was present for my first Cerec crown at the start of my restrictions. ... I felt much more confident in the Cerec process after this visit and thereby, wrongly, thought to use these new techniques and burrs that I ordered in, and did a number of crowns with this advice.

44. Counsel for the practitioner suggested that the reference to "the start of my restrictions" related to the recent approval of supervisors. It is a curious phrase as the restrictions had been in place since December. The approval of the supervisors represented a lessening of restrictions. Be that as it may, we consider it likely that the practitioner was attempting to give the impression that this was the first crown since December.

45. When the practitioner sent this email on 19 August, it must have been prominent in her mind that she had performed many crowns contrary to her conditions in June and earlier in the year. The alleged pressure to perform crowns contrary to her conditions was not new. She had been succumbing to such pressure all year. Presumably, it had been a matter of concern to her all year. The knowledge that she had been contravening her conditions all year must also have been prominent in her mind when she provided instructions in September 2020 for her solicitors to respond to the proposed immediate action.

46. We accept that the practitioner was probably under considerable pressure and not in a good mental state when she gave instructions for and swore her affidavit in November 2020. However, we cannot accept that she could have formed a positive belief in the truth of the impugned statement. A moment's serious consideration as to whether or not the statement was true would have revealed to her that it was not.

47. Given the submissions of counsel, we find that the practitioner was reckless in the sense that she gave no serious consideration as to whether or not her statement was true. This is a very serious matter. The impugned statement was made in a sworn affidavit filed for use in proceedings before the Tribunal. The practitioner admits that it constitutes professional misconduct. There is no doubt that this is so. It is conduct that is inconsistent with the practitioner being, at the time, a fit and proper person to be registered.

48. The practitioner qualified as a dentist in the United Kingdom in 2000. She has worked as a dentist in Adelaide since 2001. For a period of about 15 years, she worked at the "Preventative Dentistry" practice at Mitcham. She appears to have done so successfully and without any adverse incidents.

49. In 2016, the practitioner moved to the practice of Smile Co at Norwood. It was a different style of practice and perhaps she was less suited to this different style. More importantly, from about 2017, events and circumstances in the practitioner's personal life began to have a serious adverse effect on her professional performance and conduct.

50. The practitioner has had difficulties for some time with anxiety and depression, having been prescribed an anti-depressant since 2006.

51. She is now 45 years of age. She has two children, aged 9 and 11. They are children from a relationship which began in 2007.

52. The practitioner deposes that the relationship became "unhealthy". For reasons that we need not specify, it is suggested that the relationship was damaging to her sense of self-worth and self-esteem. It placed the practitioner under stress and created unhealthy habits such as isolating from friends and neglecting her personal finances. She describes herself as "perpetually fatigued", but unable to sleep.

53. From around 2008 the practitioner began "developing unhealthy coping strategies, which have been unhelpful and negative, such as not opening letters or emails if I have any apprehension about the contents".[24] This behaviour became worse over time.

54. In April 2017 the practitioner was diagnosed with a serious physical medical condition. She did not advise her employer or colleagues of this diagnosis and attempted initially to deal with it without support that might otherwise have been available. She required extensive investigation and treatment. This medical condition has been a substantial cause of worry and concern. Another occurrence in October 2017, which we need not specify, caused her considerable emotional pain.

55. In August 2018, following difficulties related to her partner's behaviour, the practitioner ended her relationship and her partner moved out of the home. This led to challenging negotiations in relation to issues arising from the separation.

56. Due to a combination of the above factors, the practitioner began to experience "further levels of reduced functioning".[25] She was unable to comply with financial accounting requirements, failed to submit tax returns, failed to renew her car registration (as she did not open the letter for one month), failed to pay bills (such as mobile phone and internet), was unable to face up to deadlines for important tasks, and avoided "anything that appears to be official". She deposed to observing "particularly since April 2017, chronic procrastination by me on many issues".[26]

57. The practitioner has explained how these difficulties impacted her conduct in failing to comply with the conditions of registration. She found it difficult to make arrangements for education. She found the idea of one-on-one education intimidating. She found herself unable to open emails from AHPRA.

58. Dr Maria Naso, an independent specialist psychiatrist engaged by the Board, has explained the practitioner's behaviour as follows:

Denial is the defence mechanism which Dr Cooper has been using throughout this period. It allows her to maintain the illusion of perfection. It allows her to avoid intense grief, feelings of failure and shame. It is denial which has stopped her from processing the grief and loss around her [medical condition] diagnosis.

Avoidance and procrastination are defence mechanisms seen in people who have perfectionist traits. Dr Cooper's situation with AHPRA and the Board required her to be proactive. The disciplinary action caused her a great deal of anxiety and threatened her sense of perfection. Instead of facing the problems and dealing with the expected anxiety she avoids anything confrontational. She avoids interaction where she might be judged. She avoids anything which may make her feel less than perfect. Avoidance is conscious and intentional maladaptive technique. Dr Cooper is aware that she is actively avoiding AHPRA correspondence which feels threatening to her. This is understandable given her work was the last remaining domain she could control. Her work defines her identity and gives her meaning and that is why she has been avoiding anything which may threaten her sense of self.[27]

59. The difficulties experienced by the practitioner do not in any way excuse the failure to comply with the conditions of registration or her professional misconduct in relation to record keeping or the contents of the affidavit. These difficulties do not in any way change the proper categorisation of the misconduct which is to be judged objectively. The difficulties do, however, explain the context in which such defaults occurred. It is important to consider what has been done about these underlying concerns and what can be expected in the future.

60. On 17 November 2020 the practitioner for the first time confided in her general practitioner concerning the above difficulties with her psychological health. A mental health plan was completed, and she was referred for treatment to Jill Johns, a psychologist, for an initial course of 10 treatment sessions. A report from the psychologist[28] suggests that the practitioner has actively addressed the issues identified by Dr Naso. She has taken effective steps to "come to terms" with her medical diagnosis and to address her previously avoidant behaviour, such as not opening mail or emails or not answering the telephone. The psychologist states:

This behaviour has gradually diminished and, while she still feels anxious at times, Louise utilises her "toolbox of strategies", attends to these matters with little delay, "like ripping the bandaid off", and no longer procrastinates. Similarly, Dr Naso's concerns regarding Louise's "perfectionistic tendencies" have also been addressed utilising a combination of CBT and ACT chaining techniques of questioning: "So what? ..What then?" This technique allows the anxious person to identify the problem at hand, recognise and acknowledge potential consequences, and ascertain the realistic importance and to prioritise accordingly.

I trust that the above demonstrates my belief that Louise has actively addressed and overcome her psychological, emotional and behavioural difficulties.

61. The Tribunal was advised that the practitioner intends to maintain her relationship with her treating practitioners.

62. It is also important to note that the practitioner is now in a stable and supportive relationship. Her partner has actively encouraged her to address the previous areas of difficulty. The practitioner now appears to have good support networks which will assist her in the future.

63. We received evidence as to the practitioner's good character (to which we have had regard in all aspects of our decision) and her positive attributes as a dentist.[29]

64. It is inherent in the joint submission of the parties that the practitioner is now a fit and proper person to return to practice, albeit with significant supervision and education requirements to ensure the protection of the public. We accept that assessment and add that now is probably the optimum timing for the practitioner to take advantage of the education and supervision required by the proposed conditions.

65. The Tribunal was advised that the practitioner has been offered a position at a small dental practice. The employer, a dentist, is aware of the proceedings and the proposed conditions, and is supportive of the practitioner. The proposed conditions will be closely monitored. We are confident that the public will be adequately protected.

66. It is necessary that the disciplinary action imposed by the Tribunal bring home to the practitioner and to other practitioners the fact that serious conduct of this nature will not be tolerated. The sanction must reassure the public that standards within the profession will be maintained. We consider that a reprimand and a suspension for a period of one year, together with imposition of the proposed conditions, is sufficient to achieve those objectives in the circumstances of this case.

67. The practitioner has already been suspended since 18 September 2020 as a result of this misconduct. That period should be taken into account. We will order that the period of suspension will conclude after 18 September 2021. Thereafter the practitioner will be able to resume practice subject to the stringent proposed conditions. The conditions will continue until removed by the Board or Tribunal pursuant to the provisions of the National Law.

68. The proposed conditions require that the practitioner undertake education outstanding from earlier requirements or otherwise relevant to the areas of misconduct. They require a regime of supervision for crown work similar to that imposed in 2019. They require an over-arching supervision of the practitioner's practice generally. They incorporate a comprehensive system of accountability and reporting. They are stringent, as is desirable and necessary in the circumstances. The conditions require substantial initiative from the practitioner for their implementation. It is an inherent requirement that the Board will attend in a timely manner to its responsibilities under the Conditions.

69. We have modified the proposed conditions in a minor way to ensure that their operation is clear and effective. The modifications are consistent with the need to ensure protection of the public and with our understanding of the intent of the parties. As stated above, we are satisfied that the protection of the public is adequately achieved. If the practitioner is able to take full advantage of the education and supervision, the conditions will pave the way for her return to practice as a productive member of the profession.

70. Pursuant to s 196(1) of the National Law, the Tribunal decides that the practitioner has behaved in a way that constitutes professional misconduct.

71. Pursuant to s 196(2) of the National Law, the Tribunal imposes the following disciplinary action:

(b) Having regard to the fact that the practitioner has already been suspended as a result of this misconduct since 18 September 2020, the Tribunal orders that the registration of the practitioner be further suspended up to and including 18 September 2021.

(c) The Tribunal imposes conditions on the registration of the practitioner as set out in "Attachment A" to these Reasons.

(d) The Tribunal orders that the review period for the conditions is 12 months.

72. The practitioner is to pay the Board's costs of, and incidental to, the disciplinary proceeding to be agreed, or in default of agreement fixed by the Tribunal.

73. The practitioner's registration was suspended on 18 September 2020 by way of immediate action under s 156 of the National Law. That action was taken pending the disciplinary proceedings that have now been heard and determined. There is no longer any need to protect the public by immediate action. Final orders have been made for that purpose. It is common ground that the s 156 suspension should be lifted when this Tribunal's order takes effect. From that time, it will be replaced by the suspension ordered by the Tribunal.

74. The Board seeks an order for its costs of the review proceeding. This is opposed by the practitioner.

75. The Tribunal considers that an order for costs is appropriate. Immediate action was required due to serious misconduct by the practitioner. The review proceeding was commenced by the practitioner. Although the practitioner argued that suspension was not necessary, she chose not to litigate that issue prior to the disciplinary hearing. Furthermore, both parties have now submitted that suspension until 18 September 2021 is appropriate. In all the circumstances, we consider it appropriate that the practitioner pay the costs.

76. The Tribunal's orders on the review proceeding are:

(a) The suspension under s 156 is lifted, to be replaced by the orders of the Tribunal in the disciplinary proceedings.

(b) The practitioner is to pay the Board's costs of, and incidental to, these proceedings.

77. The Tribunal has no jurisdiction or power to set aside the 2017 or 2019 conditions. However, it was common ground that the new conditions imposed by the Tribunal are designed to replace those earlier conditions. Those earlier conditions should be removed by the Board.

78. Pursuant to s 60 of the South Australian Civil and Administrative Tribunal Act 2013, the Tribunal prohibits the publication of the name of, or anything tending to identify, any patient named in the proceedings or any person who made a notification under the National Law in respect of the practitioner.

The following conditions are imposed on the registration of the practitioner:

1. The Practitioner must be supervised by another registered dental practitioner (the supervisor) when undertaking indirect restorations.

For the purposes of this condition 'indirect restorations' are defined as:

The Australian Schedule of Dental Services and Glossary item numbers 541 to 545, 551 to 556, 611, 613, 615, 618, 625, and 643.

For the purposes of this condition, 'supervised' is defined as:

Prior to undertaking any procedures, the Practitioner must consult with, and have the approval of the supervisor of the treatment plan. The supervisor is to be accessible by telephone or other means of telecommunication and available to attend the workplace to observe and discuss the management of patients and/or the performance of the Practitioner before the commencement of any indirect restorations.

The Practitioner must be directly observed by the supervisor when undertaking indirect restorations.

2. In connection with Condition 1, the following provisions apply:

1. the Practitioner must provide written notice to the Board of when she intends to commence/undertake indirect restorations; and
2. at the time of giving such notice, the Practitioner must on the approved form (HPN10) nominate a primary supervisor and at least one alternate supervisor to be approved by the Board. The Practitioner must ensure that each nomination is accompanied by an acknowledgment, on the approved form (HPNA10), from each nominated supervisor that they are willing to undertake the role of supervisor and are aware that AHPRA will seek reports from them.

1. The practitioner must not perform any indirect restoration as defined until at least one supervisor is approved and available to supervise.

3. In the event that no approved supervisor is willing or able to provide the supervision required when undertaking indirect restorations with the Australian Schedule of Dental Services and Glossary item numbers 541 to 545, 551 to 556, 611, 613, 615, 618, 625, and 643, the Practitioner must cease practice in relation to these items immediately and must not resume practice until a new supervisor has been nominated by the Practitioner and approved by the Board.

4. In addition to the requirements of condition 1, the Practitioner must only practise as a dental practitioner when supervised by another registered dental practitioner (the general supervisor) approved to act as such by the Board.

For the purposes of this condition, 'supervised' is defined as:

The Practitioner must consult with the general supervisor, who is to be accessible by telephone or other means of telecommunication and available to review patient records and attend the workplace to observe and discuss the management of patients and/or the performance of the Practitioner, when necessary and otherwise at weekly intervals.

5. The supervision must focus on the following areas of the Practitioner's practice:

f. communication with patients and supervisors and professional peers.

6. On or before 4 September 2021, the Practitioner must, on the approved form (HPN10), nominate a primary supervisor and at least one alternate supervisor to be approved by the Board. The Practitioner must ensure that each nomination is accompanied by an acknowledgement, on the approved form (HPNA10), from each nominated supervisor that they are willing to undertake the role of general supervisor and are aware that AHPRA will seek reports from them. The practitioner shall not recommence dental practice until at least one supervisor has been appointed and is available to supervise.

7. In the event that no approved supervisor is willing or able to provide the supervision required under condition 4, the Practitioner must cease practice immediately and must not resume practice until a new supervisor has been nominated by the Practitioner and approved by the Board.

8. On or before 11 September 2021, the Practitioner is to provide to AHPRA, on the approved form (HP10) acknowledgement that AHPRA may:

1. obtain information from relevant authorities (such as but not limited to Medicare)
2. obtain information and/or a report from the senior person at each place of practice on a monthly basis, and

1. obtain a report from the approved supervisors on a monthly basis.

9. Before recommencing dental practice, the Practitioner is to provide to AHPRA on the approved form (HPS10), acknowledgement from the senior person at each place of practice that AHPRA may seek reports from them.

10. The Practitioner must undertake and successfully complete a program of education, approved by the Dental Board of Australia and including a reflective practice report, in relation to record keeping, ethical conduct, cooperation with investigative authorities, swearing of affidavits and the signing of important documents.

11. The Practitioner must provide evidence to AHPRA of the successful completion of the education within 10 months of the notice of the Board's approval of the education.

12. The education must consist of a minimum number of 12 hours completed over a 9-month period.

13. On or before 18 September 2021, the Practitioner must, on the approved form (HPN11):

1. nominate a person(s) to be approved by the Board to act as educator, and
2. provide acknowledgement that AHPRA will obtain a report from the approved educator at the conclusion of the education.

14. The Practitioner must ensure that the nomination of an educator is accompanied by acknowledgement, on the approved form (HPNA11), from the nominated educator and an education plan outlining the form the education will take and how the topics of the education will be addressed.

15. Within 21 days of the completion of the education, the Practitioner is to provide:

1. evidence of successful completion of the education.
2. a report demonstrating, to the satisfaction of the Board, that the Practitioner has reflected on the issues that gave rise to this condition requiring they undertake education and how the Practitioner has incorporated the lessons learnt in the education into the Practitioner's practice.

16. At least 7 days before recommencing dental practice, the Practitioner must provide to AHPRA, on the approved form (HPC), the contact details of a senior person, such as the Senior Practice Manager, Senior Manager, Senior Partner, Proprietor, Owner, or equivalent (the senior person) at each proposed place of practice. In providing this form, the Practitioner acknowledges that AHPRA will contact the senior person and provide them with a copy of the conditions on the Practitioner's registration or confirm that the senior person has received a copy of the conditions from the Practitioner. The Practitioner will be required to provide the same form:

1. within seven days of the commencement of practice at each subsequent place of practice, and
2. within seven days of each and every notice of any subsequent alteration of these conditions.

17. All costs associated with compliance with the conditions on their registration are at the Practitioner's own expense.

[1] The National Law is to be found in schedule 2 to the Health Practitioner Regulation National Law (South Australia) Act 2010 (SA).

[2] 1938] HCA 34; (1938) CLR 336 at 362-363; Rajagopalan v MBSA [1997] SASC 6363, affirmed in Rajagopalan v MBSA [1998] SASC 7142; Neat Holdings Pty Ltd v Karajan Holdings Pty Ltd (1992) ALJR 170 per Mason CJ, Brennan, Deane, and Gaudron JJ at 170-171; NMBA v Hissey [2020] SACAT 80 at [6] - [9].

[5] The Conditions appear at C1 page 71.

[7] An error was identified in the Statement of Reasons and has been corrected by slip rule. The date has been changed from October 2020 to September 2020.

[8] Statement of Agreed Facts paras 40-47.

[9] The Panel's Decisions is regarded as previous misconduct, not part of the present allegation.

[12] Supervisor affidavits at c1 pages 411 and 473.

[14] Cf. Prakash v HCCC [2006] MSWCA 153 at [74].

[16] The appeal is to be heard as a review of the decision - see s 6A of the Act.

[21] C1 page 77, patients 30 and 31, treated on 6 and 11 August 2020.

[28] Exhibit R2 report dated 26 July 2021.