HCCC v Chowdhury

The Hearing

1. The Tribunal heard the complaints on 28 and 29 April 2015. The hearing confined itself to the making of findings in relation to the complaints. The Tribunal agreed with the parties that it was desirable to defer consideration of any disciplinary orders until those findings were known. A provisional date was fixed for the disciplinary orders hearing.
2. The documentary material before the Tribunal comprised: the applicant's bundle of documents (three volumes) filed 25 March 2015; the respondent's statement and attached bundle of documents filed 31 March 2015; and several exhibits received into evidence at hearing.
3. In its original bundle of documents for the hearing, the applicant filed Medicare records recording the number of consultations in the name of Dr Chowdhury on the eight days in question. Those records were the subject of a response in Dr Chowdhury's statement filed 31 March 2015. He questioned the accuracy of some of the items in respect of several of the patients for each of the eight days. He said that he did not have any recollection of treating those patients or making claims in relation to them.
4. During the hearing a fuller set of Medicare records were received into evidence covering all Dr Ismail's (Ex D) and Dr Chowdhury's (ex E) recorded consultations from 1 August 2012 to 28 February 2013. The period relevant to Dr Chowdhury's work at Dr Ismail's practice is 1 October 2012 to approximately 24 January 2013.
5. In addition detailed transaction print outs (downloaded from the practice's 'Insight' spread sheet payments system) were received into evidence. The first bundle (ex F) listed all the payment entries in the system against Dr Chowdhury's name, covering the period 1 October 2012 to 18 December 2012. The second bundle (ex G) listed all the payment entries in the system against Dr Ismail's name for the same period.

Imposition of Conditions

1. The respondent, Dr Chowdhury, born 1955, is of Indian background. He graduated in medicine in India in 1977. He migrated to Australia in 1982, first working in Alice Springs (1982-5), Perth (1985-2000) and then Sydney from 2000 to 2007. He did not renew his registration as a medical practitioner when it expired in April 2007. In the period prior to his decision not to renew his registration he had been working at Simply Beautiful clinic at Edgecliff, and Spectrum Health at Waverley. His practice had an emphasis on cosmetic procedures and minor cosmetic surgery.
2. At the time he decided not to renew, he had been practising subject to conditions imposed on his registration. They had been imposed in April 2004 after a performance review panel inquiry. In the period 19 July 2005 to 19 September 2006 he did not comply with a number of these conditions. In addition, he was the subject of an ongoing investigation in relation to a complaint from a female patient at the Waverley practice that he had engaged in inappropriate sexual activity with her when he visited her home in March 2003.
3. The two matters mentioned gave rise to disciplinary proceedings before the Medical Tribunal. Dr Chowdhury admitted the non-compliance with conditions, and pleaded mitigating circumstances connected to his health during the period of concern. He denied the allegation of boundary crossing in his professional relationship with the female patient. The Tribunal found the complaint not established in relation to the boundary crossing allegation. The Tribunal found him guilty of professional misconduct in relation to the non-compliance with conditions. He was prohibited from being reconsidered for registration until 27 February 2011: Health Care Complaints Commission v Chowdhury (Medical Tribunal, unreported, 10 June 2009).
4. The Tribunal's order went beyond the order sought by the applicant. Dr Chowdhury had not been warned that the Tribunal was considering a more severe penalty. The Court of Appeal held that he had been denied procedural fairness, and remitted the matter for redetermination by the Tribunal: Chowdhury v Health Care Complaints Commission [2010] NSWCA 56 (31 March 2010).
5. The Tribunal (differently constituted) found him guilty of professional misconduct in relation to the breaches of conditions. The Tribunal reprimanded him, and directed that when he is reregistered, the conditions in Annexure 2 to its reasons be imposed on his registration: Re Dr Swapan Chowdhury [2010] NSWMT 13 (20 October 2010).
6. His registration was restored on 4 October 2011 subject to the Tribunal's conditions.
7. Complaint One in these proceedings concerns his non-compliance with those conditions. Complaint Two refers to communications he made to the Medical Council about compliance which it is alleged were false.
8. Condition 1 of the conditions required him to undertake ten observer sessions with an experienced general practitioner approved by the Council. The approval was required to be obtained within two months of the date the conditions were imposed, to be completed within three months of the Council giving approval. The practitioner was to be nominated and approved within two months of registration. Within four weeks of completion of the sessions, Dr Chowdhury was obliged to provide a report covering a number of matters: session dates, lessons learned, plans for implementing practice changes based on his observations, and the report was to refer to six matters relating to medical practice, starting with basic clinical skills and diagnostic/problem solving skills. He was to provide a copy of this report to the appointed GP, and that GP was to provide the Council with a report on his progress and the authenticity of his report.
9. Condition 2 dealt with the period of six months after the tenth session. It prescribed meetings at least once a month between Dr Chowdhury and the appointed GP, of a performance review and mentoring nature going in particular to the six matters upon which he had been required to report. The process was to be guided by a report provided by the Council at the beginning of the process. Dr Chowdhury was required to make two reports in a prescribed format at the three monthly and six monthly points.
10. Dr Chowdhury obtained work at the Rosebery Medical Practice, Rosebery in November 2011. He initially worked two days a week, and that increased from mid-2012 to October 2012 to a full-time involvement, 9 to 5 on weekdays, and Saturday morning, 9 to 12.
11. Dr Chowdhury did not succeed in obtaining Council approval for a nomination of an experienced GP as required by Condition 1 until 26 September 2012. The approved doctor was Dr Nasr Ismail, the owner of the Al-Zahraa Medical Centre in Arncliffe. Dr Chowdhury commenced work at the practice in early October 2012. The Council required him to complete stage two of Condition 1 (ten observer sessions of at least four hours' duration each) by 31 December 2012. On 13 December 2012 Dr Chowdhury advised the Council's staff that he had completed the sessions and submitted a letter dated 17 December 2012 in fulfilment of his obligation to report.

Particulars of the Complaints

1. Particular 1 of Complaint One deals with the late nomination, which is admitted by Dr Chowdhury. In mitigation, his evidence was that he had tried without success for some months to find a suitable GP. He had eventually found one willing to act in December 2011, and nominated him to the Council. He said that the Council did not follow it up by writing to the doctor until February 2012, by which time he was no longer prepared to act. In his statement he named 18 doctors that he had approached to act without success.
2. Particular 2 alleges that he failed to complete ten observer sessions by 31 December 2012 or 'by any later date'. At hearing the reference to 'by any later date' was not pressed by the applicant. Dr Chowdhury admits breach of Particular 2 insofar as he did not attend ten sessions. But he maintained his assertion, first made in the letter dated 17 December 2012, that he had completed 8 sessions on the following dates: 24, 31 October 2012; 7, 14, 21, 28 November 2012; and 5 and 12 December 2012, all Wednesdays.
3. He stated that the 8 sessions of five hours had involved 40 hours of observership, and in that way, therefore satisfied the overall time requirement of the ten sessions, the conditions having prescribed that a session be a block of at least four hours. He was closely cross-examined on these assertions as to the number of sessions, the dates and their length.
4. The subject of Particular 1 of Complaint Two is an email sent by him on 13 December 2012 to the Council in which he stated 'I have completed 40 hours of observership and will also send you all the reports for the same'. Particular 1 asserts that he 'falsely stated' these matters. At hearing, he claimed that the reference to 40 hours was accurate. It was submitted on his behalf that he had made that statement in the honest belief that 40 hours' participation was compliant.
5. The subject of Particular 2 is the letter he sent to the Council which bears a date typed as follows '17 December 2012-12-31'. It was received by the addressee, an officer of the Council, on 2 January 2013. It reads as follows: Dear Amy, Re: Observation Sessions This is to inform you it has been a wonderful educational experience to have a respected and experienced GP, Dr Ismail, as a mentor. Dates attended include: 24.10.12, 31.10.12, 7.11.12, 14.11.12, 21.11.12, 28.11.12, 5.12.12, 12.12.12 Observations made covered the following: i. Basic clinical skills ii. Diagnostic/problem solving iii. Patient management iv. Interactions/communications with patients' v. Medical records vi. Other lessons Dr Ismail has been very considerate in accommodating my needs by providing an English translation where the consultations were in Arabic. So I remain grateful for him for the extra time he has had to spend, covering the basic skills and diagnostic issues. The most important part of the learning curve for me has been to observe and implement, the correct/appropriate way of consultations with reference to the Arab community and the very subtle nuances associated. This has enabled me to make the appropriate changes for community specific needs. With regard to the medical records, the surgery uses the Medical Director software, which has enabled me to keep accurate computerised records. I will be continuing my mentorship for the next six months and reposting accordingly.
6. We will set out in full Particular 2: 'In a report dated 17 December 2012 and provided to the Council on 2 January 2013, the practitioner falsely stated to the Council that: (a) he had attended observation sessions with Dr Nasr Ismail on the following eight occasions: 24 October 2012; 31 October 2012; 7 November 2012; 14 November 2012; 21 November 2012; 5 December 2012; and 12 December 2012; and (b) Dr Nasr Ismail had provided an English translation where consultations were in Arabic; and (c) Dr Nasr Ismail had covered basic skills and diagnostic issues with him.'
7. The Medical Council held a hearing under s 150 of the National Law on 4 June 2013 in relation to Dr Chowdhury's non-compliance with the conditions. The purpose of such a hearing is to consider whether it is appropriate for the protection of the health and safety of any person or persons or it is appropriate in the public interest to take action to suspend a practitioner's registration, or to impose conditions. The Council's hearing panel published its decision on 25 July 2013, and suspended his registration.
8. Particular 3 of Complaint Two is as follows: On 4 June 2013, during the proceedings before the Council under s 150 of the National Law, the practitioner falsely stated that he had provided Dr Nasr Ismail with a copy of the report referred to in particular 2 above.
9. This statement appears at p 50 of the transcript of those proceedings. Dr Chowdhury denies that the statement was false.
10. It will be seen that the allegations made under Complaint Two are grave, alleging conduct on the part of Dr Chowdhury that goes to his honesty and integrity, and lack of candour in dealing with disciplinary authorities.

Current Practice Status

1. On 25 September 2013 Dr Chowdhury applied to the Council for approval of a new mentor, Dr Mark Vic, of Bondi. On 16 October the Council agreed to allow the arrangement to proceed, despite his suspension, and imposed a condition that replicated the terms of Condition 1 of the original Tribunal order of 2010. There was no equivalent to Condition 2. (See letter, at tab 9, vol 3 of the applicant's bundle.) He completed the ten observership sessions with Dr Vic, and he and Dr Vic each submitted comprehensive, separate reports to the Council. He proceeded to apply to the Council under s 150A for review of the suspension order. He submitted a statement of attainment in respect of refresher courses and a return to work plan (involving Dr Vic). The Council's delegates heard his application on 23 May 2014, and by decision issued 30 September 2014 lifted his suspension. The order was set aside, and instead the Council imposed 12 practice conditions on his registration, the most important being that he practise in an approved group practice, that he have patient contact for no more than 16 hours a week, and no more than 4 hours in any one day, that he not practise after normal hours or to make home visits, and that he complete by 8 January 2015 a number of practical courses, and that he have an approved supervisor with whom is to meet on a fortnightly basis. Various reporting obligations were imposed.
2. So it will be seen that Dr Chowdhury is now back in practice, and the conduct the subject of these proceedings predates the steps to comply with the original conditions that have occurred since September 2013, the lifting of the suspension and his return to practice in October 2014.

Consideration

1. The applicant is required to prove its case on the civil standard - the balance of probabilities - informed by the care that should always be applied in making findings of grave misconduct or in making findings that carry serious consequences for the respondent such as loss of livelihood (Briginshaw v Briginshaw (1938) 60 CLR 336; and see further, the analysis in Henderson v Queensland [2014] HCA 52 per Gageler J at [87] ff).
2. The key areas of contest was whether or not Dr Chowdhury had undertaken eight observer sessions with Dr Ismail and had ever furnished a report to Dr Ismail for his consideration.
3. Dr Ismail and Dr Chowdhury each gave evidence.
4. In his pre-haring statements, Dr Ismail's key assertions were:

• Dr Chowdhury only ever participated in one observer session with him of two hours;
• that he often reminded Dr Chowdhury that he needed to finish his work in relation to the conditions, and that he would respond that he would do that on another day;
• that he did not provide any instruction, direction or supervisory oversight in relation to clinical skills, diagnostic issues, or the medical management of patients (specific matters the subject of condition 1);
• that he did not receive a report or any other kind of other documentation from Dr Chowdhury as required.

1. Dr Chowdhury replied to that statement in his statement filed 31 March 2015. His key points in reply were:

• There were eight sessions of a total length of 40 hours, held on 24 October 2012; 31 October 2012; 7 November 2012; 14 November 2012; 21 November 2012; 5 December 2012; and 12 December 2012, all Wednesday
• That the sessions mainly took the form of observation by him, and some discussion
• That he provided a copy of his report for the Medical Council on or about 13 December 2015 to Dr Ismail.

1. In evidence at hearing, both of them confirmed the contents of their pre-hearing statements.
2. Dr Ismail testified that when he agreed to Dr Chowdhury joining his practice and agreed to be nominated as his mentor, he understand that he had to do ten observer sessions, and had been made aware of the other conditions.
3. Dr Ismail said his practice was a busy, bulk-billing one, and he welcomed having Dr Chowdhury's assistance. Dr Chowdhury usually saw patients independently, though they were normally people already under Dr Ismail's care. Dr Ismail described his patient population as 'a very conservative Muslim community'.
4. As to the fee income that Dr Chowdhury's work generated, they had an agreement as to division of the proceeds between him and the practice (75/25). Payment records were tendered that were consistent with this evidence.
5. He agreed with Dr Ismail's account that their relationship had been good up to the time Dr Chowdhury left for his holiday in the United States before Christmas 2012. He agreed that he had decided while he was away not to continue his relationship with Dr Chowdhury, when he became aware of other aspects of his disciplinary history. His receptionist and one of the female patients had learnt from internet searches of the complaint made by the female patient against him. He said some of his patients were discontented by what they read, which reported the allegation.
6. He acknowledged that prior to going on holiday, Dr Chowdhury and he had discussed the possibility that he might get Dr Ismail an I-pad to give to his son. He agreed that Dr Chowdhury gave that to him on return, and said that he had later returned it still sealed. He agreed that he had been concerned about the remuneration split before Dr Chowdhury went on leave, and wanted to redefine it to 50/50, but that concern was not a factor in his decision to end the arrangement with Dr Chowdhury.
7. In relation to his dealings with his patients, he explained that he spoke Arabic with his Arabic-speaking patients, as most of them were; that he would see more patients than Dr Chowdhury; and that when Dr Chowdhury had been in his presence with a patient he would explain to him, if needed, what was being discussed. He acknowledged that he did not keep any record of the one observer session that he stated had taken place. He had no recollection of clinical or diagnostic skills been discussed on that occasion.
8. Dr Ismail acknowledged that he had failed, repeatedly, in the period between January 2013 and May 2013 to respond to communications from the Medical Council asking him for his report in relation to the observership. He explained his non-cooperation as being due to him feeling sorry for Dr Chowdhury and not wanting to add to his burden now that he faced suspension.
9. The cross examination of Dr Ismail concentrated heavily on his record keeping system.
10. The practice records (ex F and ex G) showed Doctor surname, claim ID, date of service, time of service, voucher status, item number, Medicare fee, item name. Dr Ismail explained the way his practice's accounting system operated ('Insight' system). The 'time of service' in the practice records, Dr Ismail explained, referred to the time the payment was received by the practice, and did not necessarily relate to the time of a consultation.
11. The Medicare records simply referred to dates of transactions, and did not make any reference to times of service. They showed such matters as patient names and item number and type. Similar information appeared in the practice records.
12. The result is that the Medicare and practice records do provide a profile of the level of activity of Dr Ismail and Dr Chowdhury over the period of interest, but they do not provide wholly reliable evidence as to the times of the day that they were engaged in consultations. They do not provide a clear picture on the important matter of how Dr Ismail and Dr Chowdhury spent the Wednesday afternoons where Dr Chowdhury claimed he was in attendance (and therefore not seeing patients) as an observer in Dr Ismail's rooms while Dr Ismail saw patients. The dates of service do provide an activity profile for those days, but they are not reliable in relation to the time of day that those services occurred.
13. In his statement Dr Chowdhury said that he only treated patients on the mornings of the Wednesdays when the observer sessions took place. He said he attended on Dr Ismail's consultations in the afternoon, and observed them. He said that Dr Ismail attended the practice every Wednesday between 2pm and 7 pm, and that is when the observer sessions occurred. He said that he told the front desk to let patients know that they were would be another doctor sitting in with Dr Ismail. In his statement of 31 March 2014 he said that he kept notes of the observer sessions in two exercise books (see para [75]).
14. At hearing he said that occasionally he would discuss one of his cases with Dr Ismail. He said they would see 4 to 5 patients an hour. He said there were sometimes objections from patients to his presence, and he would wait outside. There was no practice nurse present at any consultations.
15. Dr Chowdhury in cross examination was asked what happened to the exercise books. He said that he had them in the desk in the room he used when he was seeing patients. He said he first checked the desk in the room the day he came back from the Christmas trip, 24 January 2013. He left Australia with his wife for the United States, via Korea, on 1 January 2013 and returned by the same route on 24 January 2013.
16. He was questioned as to why he didn't make a photocopy of the contents of the exercise book before going overseas, given the importance of its contents. He said he did not anticipate they would not be there on his return.
17. He acknowledged that the room was not a secure room. He acknowledged that he was familiar with computers, and did, for example, enter consultation notes into the practice computer system. But he said that was not suitable or appropriate to use for making notes of the observation sessions.
18. He gave no evidence as to when he first drew the loss of the exercise book to the attention of others, and to any steps he took by contact to trace or locate the book. He said he first referred to this matter in his s 150 interview with the Council. (We were not able to locate the reference in our review of the transcript of the Council delegates' hearing. The reasons for decision, published later, do not refer to the point.) He said he had also mentioned the loss of the exercise book to his wife.
19. We do not accept that Dr Chowdhury kept any exercise book in which he recorded observations. A doctor faced with a loss of this kind would, we think, take immediate steps to seek to find the book, and would not have let the matter lie for months and only raise it for the first time, if he did, four months' later at the Medical Council, a point about which we have, as noted above, some doubt.
20. Had he done as he said, and kept records of reasonable detail in the exercise books, we would have expected him to be able to give in his statement prepared for the hearing or in evidence at the hearing a much more substantial account of what occurred in the observer sessions. He should have been able to cover, in general terms, the topics discussed, some illustrations drawn from his observations of the way particular conditions were treated, and ways in which his understanding had been assisted or improved. He had been issued with a template in relation to the matters to be addressed in his report, and had could have been used to give a relatively structured account of his observer sessions at a general level.
21. His letter dated 17 December 2012 to the Medical Council purported to be a report of a kind required at the end of the observer period. We have set it out in full earlier in these reasons. It did not follow the template that he had been given. It did not address with the detail appropriate any of the specific matters that were required to be covered in the observer session. It merely contained a series of basic recitals. It was not a professional response of a considered kind, which was what we see as contemplated by the nature of the obligation imposed and by the template supplied.
22. In our view the paucity of detail in this letter itself raises doubt as to whether any observer sessions of significance took place.
23. In our view Dr Ismail gave a fair account of his dealings with Dr Chowdhury. He had lent him a helping hand at the outset of their relationship, knowing that his registration was subject to conditions. He did not show great interest in their detail, and in our opinion left it to Dr Chowdhury to drive the relationship in that regard.
24. For Dr Ismail, as we see it, Dr Chowdhury's main value lay in the assistance he could give to his practice as a worker. The remuneration arrangements into which he entered were, in the experience of the professional members of the Tribunal, relatively generous ones in terms of the division of the fees as between the practitioner and the host practice. This points, we think, to an amicable relationship at that point.
25. Further, in our view, despite the challenges made of him in this regard, Dr Ismail had no reason to give incorrect evidence about the number and nature of their observer sessions.
26. The business records (Exs D, E, F and G) demonstrate, we consider, that it was a busy practice, and that the payment practices were of an orthodox kind. We reject the suggestions, raised by Dr Chowdhury's statement and his evidence at hearing, and put to Dr Ismail in cross-examination, that he was motivated to give evidence disputing Dr Chowdhury's account of the number and nature of the observer sessions, because of disharmony between them, or due to irregularities in payment arrangements.
27. We do not regard the elaborate attention given to the Medicare records and the practice accounting system's records at the hearing as affecting, in any way, our conclusion. They did, as revealed by the questioning, have some features (some double entries) which cast doubt on their accuracy. However, overall they were, we consider, a reliable record of the day to day level of work done at the practice by both Dr Chowdhury and Dr Ismail.
28. We are not satisfied for the reasons given above that any exercise books were kept by Dr Chowdhury.
29. We regard his statement that he attended eight five hour observer sessions as implausible for other reasons. The evidence is that most of the consultations undertaken by Dr Ismail were in Arabic. Dr Ismail, the records demonstrate, saw a large number of patients. He would have needed to translate what was being said to Dr Chowdhury. That would have slowed down the consultations significantly. He could not, we think, have maintained the level of consultation activity shown by the business records were he slowed down to that extent. The fact of having to engage in translation activity of this degree would itself have militated against the holding of observer sessions of the duration suggested.
30. Another factor suggests to us that it is unlikely that the number of sessions suggested by Dr Chowdhury took place. In his statement and evidence at hearing, he was critical of Dr Ismail's diagnostic and practice skills, and he had little to learn from him. We doubt that, with that predisposition, Dr Chowdhury would have submitted to observation sessions of lengthy duration repeatedly.
31. It follows in turn that we do not regard Dr Chowdhury as a witness of credit in relation to these matters.
32. We accept Dr Ismail's evidence on the key matters. It follows that we reject Dr Chowdhury's evidence going to the key matters in dispute. In our view the evidence only supports a finding that one observer session of two hours took place.
33. We accept Dr Ismail's evidence that he did not receive a copy of the report (the letter dated 17 December 2012, received by the Council 2 January 2013).
34. We are not satisfied that, apart from the two hour session recalled by Dr Ismail, that there was ever any other observation session, and in particular any session (other than possibly the two hour session) where any translation from Arabic to English occurred to assist Dr Chowdhury. We are not satisfied that there was any discussion of diagnostic and clinical skills within the framework of any observation session.

Findings in relation to Complaints One and Two

1. Particular 1 and Particular 2 of Complaint One were formally admitted. Particular 1 is that 1. The practitioner breached Practice Condition 1(a) on his registration n that from 5 December 2011 to 5 August 2012 he failed to nominate to the Council an experienced general practitioner who was prepared to report to the Council in accordance with Practice Condition 1(d) and 2(b).
2. Particular 2, with the excision of the final words 'or by any later date' which were not pressed is that: 2. The practitioner breached Practice Condition 1(b) on his registration in that he failed to undertake the ten observer sessions with an experienced general practitioner approved by the Council by 31 December 2012.
3. We have set out the three Particulars of Complaint Two earlier in these reasons. We find each of them proven. We found Complaint Two proven.

Whether 'Professional Misconduct' (Complaint Three)

1. In relation to the degree of seriousness of the conduct proven, clearly in our view the conduct, in its totality, constitutes 'professional misconduct', within the meaning of the National Law. The failure to nominate and have approved an experienced practitioner within the time required was undesirable. But we accept that Dr Chowdhury did make efforts to find a suitable practitioner, and there were three proposed to the Council, before he succeeded in making a nomination that was both approved and accepted by the nominated practitioner.
2. Had he then strictly complied with the mentorship requirements in the following three months, it may be that that first contravention would have been excused.
3. But the evidence, in our view, reveals a failure on Dr Chowdhury to ensure strict compliance. It was incumbent on him to drive the relationship with Dr Ismail in that regard. The goals of public protection and public confidence to which conditions of this kind are directed was thwarted.
4. Equally when the time came for him to report on compliance with the condition, it was his duty to be honest and candid with the supervising authority, the Medical Council, in that regard. He did not give an accurate account of the degree of his compliance with the obligation.
5. It is essential to the smooth operation of the system of regulation and discipline that practitioners are truthful and candid in their dealings with the regulatory authorities. Medical practitioners should uphold the highest standards of honesty and integrity in their dealings with those authorities. He engaged in a chain of deceitful communications with the Council about the extent of his compliance.

Order

1. The Tribunal finds the respondent guilty of professional misconduct.
2. The Tribunal will reconvene on the date already fixed, 10 August 2015 at 10am, to consider submissions in relation to the appropriate disciplinary order. If the parties wish to make written submissions, and file any material in support, the following timetable is set: Applicant to file and serve submissions within 14 days of the date of publication of these reasons. Respondent to file and serve submissions in reply within a further 14 days. I hereby certify that this is a true and accurate record of the reasons for decision of the Civil and Administrative Tribunal of New South Wales. Registrar DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated. Decision last updated: 02 July 2015