Subsequently, the Tribunal heard submissions as to whether the conduct also constituted professional misconduct, as to the appropriate sanctions, and as to costs of the two proceedings.

Held, finding professional misconduct and imposing sanctions:

• The practitioner has behaved in a way that constitutes professional misconduct;
• The practitioner is reprimanded;
• The registration of the practitioner is cancelled;
• The practitioner is disqualified from applying for registration as a registered health practitioner for a period of 5 years;
• The practitioner is prohibited from providing any health service (including counselling) until he is returned to the register of health practitioners.
• The practitioner should pay 80% of the costs of the two proceedings.

Health practitioners - Complaint by the Psychology Board of Australia - Professional misconduct - Failure to comply with conditions of registration - Reprimand - Registration cancelled - Disqualified from applying for registration for five years - Prohibited from providing any health service until re-registered

Health and Community Services Complaints Act 2001 ss 56B, 56C

Health Practitioner Regulation National Law (South Australia) Act 2010 sch 2 ss 5, 193, 199

South Australian Civil and Administrative Tribunal Act 2013 s 36

Cooper v Dental Board of Australia [2021] SACAT 51

Health Care Complaints Commission v Cele [2021] NSWCATOD 221

Marin v Chiropractic Board of Australia [2020] SASCFC 74

Medical Board of Australia v Lloyd [2021] SACAT 96

Medical Board of Australia v Murphy [2020] SACAT 112

Medical Board of Australia v Nicholas [2022] SACAT 98

Medical Board of Australia v Piesse [2022] VCAT 82

Medical Board of Australia v Redzepagic (No 2) [2023] VCAT 93

Medical Board of Australia v Salter [2022] VCAT 1238

Nursing and Midwifery Board of Australia v Szkup [2022] SACAT 18

Nursing and Midwifery Board of Australia v Tay [2024] SACAT 9

Osteopathy Board of Australia v Ratliff [2021] VCAT 658

Prakash v Health Care Complaints Commission [2006] NSWCA 153

Mr A Schatz with Mr T Ward appeared for the Psychology Board of Australia

The Tribunal has prohibited the publication of the names of, or any material tending to identify, any client or patient of Mr Fletcher.

1. There are two matters before the Tribunal.
2. Matter 2022/SHP000030 (the appeal) concerns an application by which Mr Fletcher sought to appeal under s 199 of the Health Practitioner Regulation National Law (South Australia) (the National Law),[1] from a decision made by the Psychology Board of Australia (the Board) on 4 November 2022. The Board imposed conditions on his registration. By a Statement of Reasons issued on 17 July 2025, the Tribunal determined that appeal and confirmed the decision that was subject to review. The only remaining issue in respect of those proceedings is an application by the Board for costs.
3. Matter 2024/SHP000013 (the disciplinary proceedings) concerns a referral made by the Board under s 193 of the National Law, alleging that Mr Fletcher has been guilty of "professional misconduct", in that he has failed to comply with the said conditions.
4. By the Statement of Reasons issued on 17 July 2025, the Tribunal has already determined that Mr Fletcher failed to comply with the conditions and that such non-compliance amounted to "unprofessional conduct" as defined in the National Law. The Tribunal indicated that it would hear further submissions as to whether the conduct also constituted "professional misconduct" as defined in the National Law, and as to the appropriate sanctions. The Board had also foreshadowed an application for costs.
5. The further hearing took place on 24 September 2025. The Tribunal reserved its decision, and that decision is now set out in this Statement of Reasons. The Tribunal will first address the remaining issues in the disciplinary matter, before turning to the application for costs.

Did the conduct amount to "professional misconduct"?

1. We do not intend to repeat the content of the Tribunal's Statement of Reasons issued on 17 July 2025. What follows is to be read in conjunction with that Statement of Reasons.
2. In very broad summary, the Tribunal found that the Board lawfully decided on 4 November 2022 to impose conditions on Mr Fletcher's registration. He was advised of that decision by letter dated 18 November 2022. The conditions required him to undertake education and to submit to audit of his practice.
3. The Tribunal also found that the imposition of those conditions on Mr Fletcher's registration was both appropriate and necessary.
4. The Tribunal noted that there was no application to stay the conditions imposed by the Board and that those conditions were lawfully in operation at all times after 18 November 2022.
5. The Tribunal also noted that the Board had on 8 August 2023 (after following the relevant statutory processes) formally cautioned Mr Fletcher under s 178 of the National Law concerning his failure to comply with the conditions.
6. The Tribunal noted that Mr Fletcher continued in his failure to comply.
7. The Tribunal ultimately found that Mr Fletcher had at no time complied with the conditions. Indeed, Mr Fletcher did not contend otherwise. He conceded that he had not complied and indicated that he did not intend to comply.
8. Hence, the Tribunal found that he had contravened the conditions of his registration and that conduct constituted "unprofessional conduct".[2]
9. On 24 September 2025, the Tribunal heard submissions from Mr Fletcher as to whether his conduct also constituted "professional misconduct". The definition of "professional misconduct" in s 5 of the National Law is as follows:

professional misconduct, of a registered health practitioner, includes -

(a) unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and

(b) more than one instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and

(c) conduct of the practitioner, whether occurring in connection with the practice of the health practitioner's profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession.

1. The Board submitted that the conduct of the practitioner in failing to comply with the conditions of registration constituted "professional misconduct" under both paragraphs (a) and (c) of the definition.
2. The Board referred to various authorities which suggest that conditions of registration must be scrupulously observed.[3] These cases demonstrate that a deliberate breach of conditions is a very serious matter. They demonstrate that such breaches will normally be regarded as "professional misconduct".
3. As this Tribunal said in the matter of Cooper v Dental Board of Australia:

The Conditions had been imposed to protect the public and ensure the maintenance of appropriate standards of treatment. Such conditions must be scrupulously observed. 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.[4]

4. In the present case, Mr Fletcher considered that there was nothing wrong with his practice of the profession. He considered that the conditions were unnecessary and ought not to have been imposed. He suggested that the Board acted maliciously and for an improper purpose. He maintained these views despite the earlier decision of this Tribunal in July 2022 which, although it related to an earlier sequence of events, clearly suggested that his views were misconceived. Hence, he did not comply with the conditions and had no intention of doing so.
5. Mr Fletcher's conduct in failing to comply with the conditions was contumacious and persistent. It is conduct that strikes at the heart of the regulatory and legislative system. If such conduct was commonly followed by practitioners, the effective regulation of the profession would be seriously impaired.
6. We have no hesitation in finding that the conduct of the practitioner in failing to comply with the conditions of his registration was professional misconduct. It was conduct which was substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training and experience. It was also conduct which was inconsistent with the practitioner being a fit and proper person to hold registration in the profession.
7. In reaching these findings we have had regard to the fact that Mr Fletcher was initially deprived of the opportunity of challenging the imposition of the conditions. This is explained in our previous Statement of Reasons.[5] However, two points must be made. Firstly, there was no application under s 36 of the South Australian Civil and Administrative Tribunal Act 2013 (the SACAT Act) to stay the operation of the conditions. Mr Fletcher was not entitled to simply treat them as though they were invalid. They were validly imposed and binding on him. Secondly, Mr Fletcher's attitude towards the conditions has remained unchanged, even after the dismissal of his appeal by this Tribunal.[6] He has continued to reiterate his position that the conditions are inappropriate and unnecessary and that he will not comply with them. He cannot (and does not) contend that his contravention of the conditions was a result of the initial failure to process his appeal.
8. The Tribunal makes a formal finding pursuant to s 196 of the National Law that the practitioner has behaved in a way that constitutes professional misconduct.

1. The Tribunal heard submissions from both parties as to the appropriate sanctions. It was clearly articulated that these sanctions were to be imposed with respect to Mr Fletcher's conduct in failing to comply with the conditions of his registration. The sanctions were not being applied in respect to the alleged conduct of Mr Fletcher which led to the imposition of the conditions.
2. Nonetheless, it is relevant in relation to the issue of sanctions to consider the reasons why Mr Fletcher failed to comply with the conditions and the degree of insight which he has exhibited in relation to the inappropriateness and unprofessional nature of his conduct.
3. In making submissions on sanction, Mr Fletcher focussed on arguments to the effect that the findings of this Tribunal in July 2025 were wrong. He reiterated his view that he had done nothing wrong, that the conditions ought not to have been imposed, and that what he was doing was the right thing. He suggested that the conditions were imposed upon him because he refused to conceal child abuse. He suggested that he was about to have sanctions imposed on him for the same reason. He reiterated his view that the Board had acted maliciously and suggested that the Board wished to punish his clients.
4. Mr Fletcher insisted that his view of the matter was "the truth". Those who expressed any different view were "lying" and were acting maliciously. They were complicit in concealing child abuse.
5. Despite having matters explained to him very clearly on many occasions (including in the formal decisions of this Tribunal), Mr Fletcher continues to make statements which are fundamentally and demonstrably incorrect. He continues to exhibit absolutely no insight into the fact that his conduct was unprofessional, let alone any insight into its seriousness.
6. Furthermore, it is apparent that the reason for Mr Fletcher's misconduct is that he totally rejects the criticism of his professional practice and regards those who have made such criticisms as having acted maliciously. He has maintained this view despite the findings of the Tribunal which are clearly to the contrary. Because he regards the criticism of his practice as wrong, he takes the view that the conditions imposed by the Board were imposed maliciously and for an improper ulterior motive and that the conditions are totally unnecessary. He takes the view that the only course open to him is to refuse to comply with the conditions. He persists in these views despite the findings of this Tribunal that the conditions were imposed lawfully and appropriately.
7. Health Care Complaints Commission v Cele[7] was a case in which a nurse refused to comply with the conditions of her registration. In cancelling her registration, the New South Wales Tribunal stated:

The respondent held a view that the conditions were not relevant because she thought she was competent. That speaks highly of her lack of insight of the risk to the safety of patients. This is significant in a protective jurisdiction.[8]

8. In summary, Mr Fletcher is unwilling to accept appropriate decisions and actions of the regulator and unwilling to comply with lawful requirements under the regulatory scheme. He maintains this stance despite clear decisions of this Tribunal which confirm that his views are misconceived and that he is acting unprofessionally.
9. In these circumstances, we must inevitably find that Mr Fletcher is not a fit and proper person at the present time to be registered as a health practitioner. Furthermore, it appears unlikely that his views will change in the future to the extent that he may eventually become a fit and proper person to be registered.
10. In making these findings, we wish to emphasise that it is not a reflection on Mr Fletcher's general character or his honesty. We consider that he is well-intentioned and that he genuinely cares for his clients. However, that does not equate with fitness to be registered in circumstances where he will not abide regulation of his practice or operate within the legislative regime.
11. We have had regard to Mr Fletcher's personal circumstances. He advised us that he had practised with distinction for over 50 years. He said he had achieved hundreds of leadership positions. He said he had always followed the requirements of professional conduct. His approach was always to know the right thing to do and to do it.
12. Mr Fletcher indicated that he had spent many years working in the area of child abuse and that he was always seeing needy people, often on a pro bono basis. He pleaded with the Tribunal to allow him to continue to assist these people. He indicated that he has a 16-year-old daughter and that he is currently in debt.
13. Whilst we have regard to the personal circumstances of Mr Fletcher, they cannot distract us from our duty to act in the protection of the public.
14. The Board proposed that the Tribunal should impose the following sanctions:

(a) a reprimand;

(b) cancellation of registration;

(c) disqualification from making an application for registration as a registered health practitioner for a period of five years; and

(d) prohibition from providing, whether as a sole practitioner, employee, contractor, manager or volunteer, and whether directly or indirectly, any health service (including counselling) until such time as he is returned to the register of health practitioners.

1. We consider that the sanctions sought by the Board are appropriate and necessary in this case. Mr Fletcher's contumacious and persistent conduct in refusing to comply with the conditions of his registration cannot be tolerated. It requires a reprimand. It is inconsistent with fitness to be registered and requires cancellation of his registration.
2. We consider that disqualification for a period of five years is necessary and appropriate for a number of reasons. Firstly, Mr Fletcher's contumacious conduct has continued over a lengthy period of time. It is based on erroneous views which appear to have become hopelessly entrenched. Protracted proceedings before this Tribunal have not led to any substantial insight. It is difficult to foresee any change in this situation in the future. There is a current unfitness to be registered and that is unlikely to change. Whilst a period of disqualification must be set, premature and unmeritorious applications for reinstatement should be discouraged.[9]
3. Secondly, a very substantial disqualification is required to bring home to Mr Fletcher and to other members of the profession that deliberate breaches of the conditions of registration will not be tolerated and will be met with substantial sanctions. Such conduct must be deterred if the integrity of the regulatory scheme is to be maintained.[10]
4. Thirdly, a substantial disqualification is required to assure members of the public that the profession is being appropriately regulated and that such breaches will not be tolerated. Public confidence in the regulatory scheme is of the utmost importance.[11]
5. We note that Mr Fletcher will not be able to automatically return to practice after the period of disqualification. This is the period after which he may apply for reinstatement. He will then have to convince the Board that his disqualifying factors are no longer operative and that he is then a fit and proper person to be registered.
6. The prohibition from providing any health service is necessary and appropriate, in our view, for two reasons. Firstly, it is important that a person disqualified from applying for registration as a health practitioner cannot be seen to circumvent the regulatory system by providing unregulated health services as, for example, a counsellor.[12] It is essential that public confidence in the provision of health services be maintained. Secondly, there is an ongoing risk to the public as a result of Mr Fletcher's unwillingness to entertain valid criticism of his manner of practice and to comply with lawful regulation of his practice. Even unregistered providers of health services may have conditions or restrictions imposed on them and it is essential to the safety and welfare of the public that such conditions, as well as legislative requirements, be obeyed. See, for example, ss 56B and 56C of the Health and Community Services Complaints Act 2004. The prohibition should remain until Mr Fletcher has demonstrated that his disqualifying features are no longer operative.[13]
7. We therefore impose the various sanctions that have been proposed by the Board. Insofar as we impose a prohibition for the provision of health services, we note that the reference in that prohibition to "health services", is intended to embrace the meaning that the expression "health services" has under the National Law.
8. We will make the sanctions imposed by the Tribunal effective from 5pm on Thursday, 23 October 2025. This will allow Mr Fletcher time to finalise his current practice in an orderly and appropriate manner and to refer his clients to other registered practitioners as required.

1. Mr Fletcher argued that each party should bear its own costs. We do not agree. The Board has been entirely successful in both proceedings. Mr Fletcher persisted in factual assertions that were demonstrably wrong, even after the decision of the 2022 Tribunal which essentially found to the contrary. He persisted in arguments that were fundamentally flawed. The Board should have its costs of both proceedings, albeit with a slight adjustment.
2. As we pointed out to counsel for the Board at the final hearing, there was an application by the Board for the striking out of material filed by Mr Fletcher. The Tribunal held a hearing to consider that application and it was dismissed. Counsel agreed that the costs of that application should not fall on Mr Fletcher. Furthermore, Mr Fletcher was through no fault of his own put to the cost of a hearing as to the status of the 2022 application. That was, of course, not the fault of the Board, but it is of some relevance.
3. Taking these two circumstances into account, and adopting a very broad-brush approach, we consider that the Board should have an order for payment by Mr Fletcher of 80% of the total costs of the two applications.

1. The Tribunal decides pursuant to s 196(1) of the National Law that:

1.a. The practitioner has behaved in a way that constitutes professional misconduct.

1. The Tribunal imposes the following disciplinary action:

2.b. Effective from 5pm on Thursday, 23 October 2025,

(a) the registration of the practitioner is cancelled;

(b) the practitioner is disqualified from applying for registration as a registered health practitioner until 23 October 2030; and

(c) the practitioner is prohibited from providing, whether as a sole practitioner, employee, contractor, manager or volunteer, and whether directly or indirectly, any health service (including counselling) until such time as he is returned to the register of health practitioners. "Health service" has the meaning that it bears in the National Law.

1. The practitioner must pay 80% of the costs of the Board in matters 2022/SHP000030 and 2024/SHP000013 to be agreed or, in default of agreement, to be fixed by the Tribunal.

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

[2] As defined in s 5 of the National Law.

[3] Prakash v Health Care Complaints Commission [2006] NSWCA 153 at [74]; Medical Board of Australia v Murphy [2020] SACAT 112 at [189]; Cooper v Dental Board of Australia [2021] SACAT 51 at [34]; Medical Board of Australia v Lloyd [2021] SACAT 96 at [26]; Nursing and Midwifery Board of Australia v Szkup [2022] SACAT 18 at [12] and [15]; Medical Board of Australia v Salter [2022] VCAT 1238 at [111] and [113]; and Medical Board of Australia v Redzepagic (No 2) [2023] VCAT 93 at [20].

[4] Cooper v Dental Board of Australia [2021] SACAT 51 at [34].

[5] Statement of Reasons dated 17 July 2025 at [10]-[22].

[6] Statement of Reasons dated 17 July 2025.

[7] [2021] NSWCATOD 221.

[8] [2021] NSWCATOD 221 at [51].

[9] Marin v Chiropractic Board of Australia [2020] SASCFC 74 per Kourakis J (Peek and Nicholson JJ agreeing) at [70]-[72]; Medical Board of Australia v Nicholas [2022] SACAT 98 at [47].

[10] Marin v Chiropractic Board of Australia (ibid) at [73]; Medical Board of Australia v Nicholas (ibid) at [47].

[11] Marin v Chiropractic Board of Australia (ibid) at [73]; Medical Board of Australia v Nicholas (ibid) at [47].

[12] Marin v Chiropractic Board of Australia (ibid) at [73]; Osteopathy Board of Australia v Ratcliff [2021] VCAT 658 at [144].

[13] See Medical Board of Australia v Piesse [2022] VCAT 82 at [[175]- [178], Nursing and Midwifery Board of Australia v Tay [2024] SACAT 9 at [15]- [27].