Health Care Complaints Commission v Suri [2025] NSWCATOD 43

(b) To advise the Medical Council of NSW in writing at least seven days prior to changing the nature or place of the practitioner's practice.

(c) To practise only in a group practice approved by the Medical Council of NSW of at least 2 other registered medical practitioners, and:

(i) Where the patients and patient records are shared between the medical practitioners;

(ii) Where there is always one other registered medical practitioner on site.

(d) Not to undertake any invasive skin procedures for either diagnostic or therapeutic purposes with the exception of:

(ii) 30029 - skin and subcutaneous tissue or mucous membrane, repair of wound;

(e) Audit - the practitioner shall submit to an audit of his medical records by a random selection of his medical records by a person or persons nominated by the Council: and

(i) the audit is to be within 6 months of the practitioner recommencing practice;

(ii) the practitioner is to authorise the auditor to provide the Council with a report of their findings; and

(iii) the practitioner is to meet all costs associated with the audit and any audit report.

(i) The practitioner shall nominate a supervisor prior to recommencing practice to be approved by the Council, to monitor and review his clinical practice in accordance with the Council's Compliance Policy - Supervision;

(ii) The supervisor is to be provided with a copy of the Council's Compliance Policy and a copy of the Tribunal's decision;

(iii) The cost of the supervision is to be borne by the practitioner;

(iv) The practitioner and the supervisor are to meet on a fortnightly basis for at least one hour;

(v) At each meeting, the practitioner and the supervisor are to address the matters highlighted as concerns in the Tribunal's decision as well as issues arising from his recommencement of practice after any period of suspension;

(vi) At each meeting the supervisor is required to complete a record of matters discussed in a form approved by the Council;

(vii) The practitioner is to authorise the supervisor to forward supervision reports to the Council on a three monthly basis in a format approved by the Council;

(viii) The supervisor is to inform the Council immediately if there is any concern in relation to the practitioner's compliance with the supervision requirements, other conditions of registration, clinical performance or if the supervisor relationship ceases;

(ix) The requirements of Category C supervision as set out in the Council's Compliance Policy (Supervision) apply. However, where this condition varies that policy, this condition prevails;

(x) The practitioner is to meet all costs associated with this condition.

(g) The Medical Council of NSW is the appropriate review body for the purposes of Division 8, Part 8 of the Health Practitioner Regulation National Law (NSW).

(3) The Respondent is to pay the costs of the HCCC as agreed or as assessed.

(4) Pursuant to s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW), the disclosure of the name of any patient referred to in the proceeding is prohibited.

HEALTH - medical practitioner - HEALTH misconduct and discipline - unsatisfactory professional conduct - professional misconduct - suspension - conditions imposed on licence

Pursuant to s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW), the disclosure of the name of any patient referred to in the proceeding is prohibited.

1. This is the Stage Two hearing in this matter.
2. On 3 December 2024 the Tribunal published its decision in relation to Stage One and made the following orders:

(1) The Respondent is guilty of both unsatisfactory professional conduct and professional misconduct.

(2) The matter is listed for the Stage 2 hearing on 12 March 2025.

1. The Heath Care Complaints Commission (HCCC) relied on the following documents in the Stage Two hearing:

(1) The Stage One evidence and decision.

(2) Exhibit A1: HCCC material in the Stage Two Proceedings.

(3) Exhibit A2: Email from the Medical Council of NSW to the HCCC dated 12 March 2025. Also attached AHPRA & National Boards Evidentiary Certificate.

(4) MFI 1: Written submission of the HCCC.

1. The Respondent relied on the following documents in the Stage Two hearing:

(1) Exhibit R1: The Respondent's Stage Two bundle of documents.

(2) Exhibit R2: Bundle of correspondence re Conditions.

(3) MFI 2: The Respondent's outline of submission Stage Two.

1. In relation to exhibit A1 we noted the following in particular.
2. The conduct of the Respondent, the subject of the findings at Stage One, occurred between 2017 and 2021. The conduct which gave rise to the investigation and the action which ultimately came before the Tribunal was commenced by a complaint made by a colleague of the Respondent on 24 May 2021. At that time the Respondent was the subject of conditions attached to his registration. Between 1998 and 2021 the Respondent had been the subject of 13 previous complaints. One of those complaints led to the Respondent being the subject of a Tribunal order suspending his registration for a period of three months. That occurred in May 2016.
3. The HCCC included in exhibit A1 copies of supervision reports for the Respondent created between January 2018 and June 2022. There are 23 supervision reports and one Performance Assessment Report.
4. Also included in exhibit A1 are three Audit Reports dated between 2017 and 2019 and a Medical Record Audit Summary dated 23 November 2021.
5. We have had regard to all the documents contained in exhibit A1.
6. Exhibit A2 consists of an email from an officer at Ministry of Health dated 12 March 2025. That email explains that there is information about the Respondent which is not contained in the Evidentiary Certificate provided by the Australian Health Practitioner Regulation Agency (AHPRA). The information includes that in September 2023 the Respondent underwent a Performance Assessment. In December 2023 the Medical Council of NSW (Medical Council) Committee resolved to offer conditions under s 155C of the Health Practitioner Regulation National Law (NSW) (National Law) and should the Respondent consent to those conditions, his s 150 conditions would be removed (including conditions 12 and 13). If not consented to, the Medical Council Committee would require a Performance Review Panel to be convened. The Respondent raised questions about the conditions proposed. The Medical Council considered that again in March 2024 and offered further conditions, stating that if consented to, the s 150 conditions then in force would be rescinded. In short, the Respondent has not consented to the conditions offered and the Medical Council was in the process of arranging a further Performance Review Panel to consider the Respondent's case.
7. The AHPRA Evidentiary Certificate contains an extensive history of imposition of conditions and notes the suspension imposed by the Tribunal.
8. Exhibit R1 for the Respondent includes a number of documents which are identified in the index. The first document which we have considered is a statement of the Respondent dated 4 March 2025. We have noted the following in particular in that document:

(a) The Respondent has read the decision of the Tribunal delivered on 3 December 2024. He accepts there were a number of shortcomings on his behalf in relation to the management of the patients referred to in that judgment. He extensively listed the mistakes he had made and what he considers he should have done with the management of those patients. He concluded by stating that he was very sorry for the suffering that he caused to his patients and specifically Patient C who he treated on many occasions.

(b) The Respondent set out the additional educational activities he has engaged in since coming to the attention of the Medical Council in June 2021. In September 2023 the Respondent underwent a Performance Assessment. He stated the assessment found he was performing satisfactorily in all areas which were assessed.

(c) The Respondent has enrolled in a course conducted by the University of Sydney. That was to commence in February 2025.

(d) The Respondent stated: "As a result of my learnings, I am now also making detailed and specific medical records which I believe would accord with acceptable practice. I am also providing patients with options of non-invasive treatment of skin cancers where that is appropriate, and I offer specialist referrals for large lesions or those in sensitive areas. I am not performing any large excisions which would require closure with a surgical flap or graft."

(e) The Respondent then addressed matters relating to his treatment of Patient C. He expressed remorse for the "stress and upset" he caused Patient C. He also said: "I deeply regret my actions in relation to contacting Patient C, asking him to meet with me and attempting to persuade him to withdraw his complaint. That was completely inappropriate."

(f) In relation to the Tribunal's finding that the Respondent offered Patient C a payment of $1,000 to withdraw his complaint, the Respondent said he had no recollection of that. He accepts the finding in relation to the offered payment and stated: "[I] can only think I made the offer in a moment of sheer panic."

(g) The Respondent then addressed his proposals for future practice. He has a great desire to continue practising as a medical practitioner.

1. Included in exhibit R1 is a copy of the Performance Review dated 5 October 2023. In that we note the following:

(1) The Respondent was 62 years of age and has General Practice Speciality registration.

(2) The Respondent is the subject of 16 prior complaints. We note it does not state how many of those were found as established. The document does note the dates of imposing of conditions on the Respondent's registration, commencing in 2016.

(3) In assessing the Respondent's performance in the area of practical/technical skills in skin cancer medicine, the assessors noted: "[W]e are concerned that having not undertaken any skin cancer surgery for some time, in particular more complicated excisions such as flaps - that he may now be deskilled. ... We support [a plan that] Dr Suri not be permitted to undertake flap surgery until he has successfully undertaken [the Skin Cancer College of Australasia's course on flaps]".

(4) The assessors concluded: "Dr Suri's performance in the area of advanced practical and technical skills in skin cancer medicine is unsatisfactory".

(5) The conclusion of the assessors was that the Respondent's professional performance was satisfactory except for practical/technical skills in advanced flap skin cancer excisions.

1. The Respondent included in exhibit R1 a number of personal references which we have read. One of the references is from Dr Kalra who is very supportive of the Respondent. Two of his references are personal references from professional men outside of the medical field. Those references speak very highly of the Respondent. Another reference is from a medical practitioner who is a patient of the Respondent. His reference is very supportive. His final reference is that of Dr Michael Liang who had been the Respondent's approved supervisor under the conditions which were attached to his registration between 2016 and 2024.
2. In the reference from Dr Liang we particularly noted the following:

"With regards to skin lesion management findings, I have some prior knowledge as I was notified by the medical council in 2021 that Dr Suri had new conditions restricting his performance of skin procedures. Dr Suri had explained to me at the time this was due to patient complaints at another practice prior to 2021. What I have observed since then is Dr Suri's willingness to acknowledge his mistakes and to focus on improving his short comings. I know he has since upskilled his skin cancer management by obtaining a Certificate in Skin Cancer Medicine through the Skin Cancer College of Australasia. With Medical Council approval in 2022, I was requested by Dr Suri to observe a few of his procedures as required for obtaining his Certificate, which I found was performed satisfactory."

1. Exhibit R2 is a bundle of emails and attachments which explain the circumstances surrounding the conditions attached to the registration of the Respondent at the time of the hearing. In the last of the emails from the Respondent's solicitor to the Ministry of Health, we note the following.

"In respect of proposed Condition number 2 and Dr Suri's declining to consent to it, Dr Suri instructs me:

He is now 63 years of age.

He does not propose to practise in a skin cancer setting or dedicated practice.

He does not propose to undertake any skin excisions which would require a graft or flap to effect closure.

He is content to practice in general practice and to undertake, as permitted, routine skin excisions and two on-refer patients with lesions that may require larger excision and secondary closure.

He is content not to undertake any procedures that may fall within the descriptors of Medicare Benefits Schedule ('MBS') items 45201, 45202, 45206, 45400, 45451 and 45665.

Given those circumstances, he does not believe that there is any utility in his undertaking the proposed course."

1. The Tribunal members asked the Respondent a number of questions to assist with this determination. As a result we noted the following:

(a) The Respondent works four days a week now. His practice is at North Rocks, a suburb of Sydney.

(b) The Respondent is very particular about obtaining informed consent.

(c) The practice has nursing staff who assist with procedures.

(d) The Respondent is conducting cryotherapy, removal of skin tags, punch biopsies and shaved biopsies. This work represents about 5% of his work as a medical practitioner.

(e) He undertakes geriatric and mental health work including creating mental health plans. That represents about 50% of his work now.

(f) Dr Liang is his level B approved supervisor. He does not work in the same practice.

(g) He sees 33 to 35 patients a day. The practice is open from 8am to 5pm.

1. The Respondent was then asked questions by his senior counsel. We noted the following from that evidence.

(a) The Respondent said that his meeting with Patient C occurred as a result of pure panic. He said he should not have done it. It was impulsive.

(b) The practice in which the Respondent works has five other practitioners working there. They have formal meetings every six to eight weeks.

(c) The Respondent is content to restrict his skin cancer work to the limited area he is currently undertaking. He would like to work for another seven to eight years. He is now 64 years of age.

1. The Respondent was cross-examined by counsel for the HCCC. We noted the following from that evidence.

(a) It was put that the Respondent currently has a condition on his registration that requires he does not undertake invasive skin procedures, subject to some exceptions. The Respondent said those conditions were removed in October 2023 following the performance assessment. He said he has been undertaking biopsies with the Medicare item number 30071. He started that in 2024 when he was told his condition preventing same was removed.

(b) The Respondent was asked why he thought his conditions numbered 12 and 13, which restricted his skin procedures, were removed. He said that the performance review had recommended the condition be removed. He said: "After that I thought everything had been ironed out and no conditions. All had gone."

1. As noted earlier from exhibit R2, the conditions on the Respondent's registration had not been removed as he was in conflict with the regulatory authority as to the wording of proposed conditions.
2. The Respondent was asked further questions by the members of the Tribunal. In answer to a question asking how he could assure the Tribunal that he will be safe to practise skin cancer medicine in the future, the Respondent told the Tribunal that he has undertaken a considerable amount of learning since the 2021 complaint. He is encouraging his patients to consider alternate procedures to excision of lesions. He asks if they would prefer a referral to a specialist skin cancer GP.
3. Each of the parties provided written submissions on the day of the hearing and also provided oral submissions.

1. The HCCC's written submission was marked as MFI 1. In that we noted the following in particular.
2. The HCCC recommends that an appropriate protective order in this case is cancellation of registration with a twelve month non-review period.
3. The HCCC then addressed the principles to be applied in the subject case. It addressed the relevant sections of the National Law and the decisions which have informed the application of those sections. It addressed the objectives of the National Law. It addressed matters of specific and general deterrence and the maintaining of the public confidence in both the medical profession and the regulatory bodies administering the National Law. It submitted: "Members of the public should be comfortable that a registered practitioner has the willingness and capacity to act with integrity, trustworthiness and high moral and ethical values, to comply with relevant regulatory requirements and codes of practice, and to treat patients competently and safely."
4. The HCCC submitted:

"In determining what protective orders accord with these objectives, it is relevant for the Tribunal to consider:

(a) whether the misconduct could be satisfactorily explained as an error of judgment rather than a defect of character;

(b) the intrinsic seriousness of the misconduct in terms of fitness to practise;

(c) whether the misconduct should be viewed as an isolated episode and hence atypical or uncharacteristic of the practitioner's normal qualities or character;

(d) the motivation which may have given rise to the proven episode of misconduct;

(e) the underlying qualities of character shown by previous and other conduct; and

(f) whether the practitioner's conduct post the proven episode of misconduct demonstrates the public and professional confidence may be reposed in them to uphold and observe the high standards of moral rectitude required of a health practitioner."

(omitting footnotes)

1. The HCCC then addressed the specific reasons why the Respondent should have his registration cancelled. In that the HCCC included the following:

_"_10. First, the conduct that the Tribunal found to be proved was serious and warrants a significant measure of denunciation and general deterrence.

11. The Tribunal found serious deficiencies in the Respondent's treatment, record-keeping and Medicare claiming in relation to three patients (Patients A, B and C, together Patients) over a cumulative period of approximately four years. In summary, the Tribunal found:

(a) The Respondent excised skin lesions unnecessarily from all three Patients (complaint 1, particulars 1, 4, 11, 13, 16, 18, 20, 22, 24, 26 and 29): J [120]-[121]. This included 10 discrete excisions as well as the majority of the 48 lesions excised from Patient C: J [141(5)].

(b) The Respondent used a 'flap repair' procedure on Patients A and B to close wounds caused by his excisions in circumstances where that form of closure was not necessary or appropriate, including having regard to the Respondent's level of training (complaint 1, particulars 6, 10 and 14): J [120]-[121].

(c) The Respondent failed to obtain the Patients' informed consent to those procedures (complaint 1, particulars 2, 5, 7, 12, 15, 17, 19, 21, 23 and 25): J [120]-[124]. Contrary to the Respondent's denial, the Tribunal accepted that on eight occasions the Respondent did not discuss any alternative treatments with the relevant Patient: J [123].

(d) Respondent failed to properly diagnose and manage the Patients' skin conditions, including by failing to offer Patient A a specialist referral for the excision of a lesion in a cosmetically sensitive area (complaint 1, particular 3); ...

(e) The Respondent made inappropriate statements to Patient C including to the effect that lesions on his body would likely be fatal if not removed, that his previous doctors had missed potentially fatal lesions, and that he was riddled with pre-melanomas, despite knowing that Patient C had been diagnosed with anxiety and depression and had a fear of developing cancer (complaint 1, particular 28): J [30], [125].

...

(g) The Respondent made Medicare claims in relation to all three Patients which he should not have made, including because the Medicare Benefits Schedule (MBS) item number for which the Respondent claimed was inappropriate for the nature of the lesion; ...

(h) The Respondent attempted to persuade Patient C not to continue with his complaint to the Commission against him, including by offering Patient C $1,000 to withdraw his complaint, contrary to the Respondent's denial: J [130]-[137], [141(11)].

(i) The Respondent was guilty of unsatisfactory professional conduct in relation to each of complaints 1 to 4: in the case of complaints 1 to 3, by reason of his conduct being significantly below the standard reasonably expected of a practitioner of equivalent skill, training and experience (s 139B(1)(a) of the National Law) (J [124], [126]-[127], [129]); in the case of complaint 2, also by reason of his conduct being contrary to the record-keeping requirements in the Health Practitioner Regulation (NSW) Regulation 2016 (NSW) (Regulation) (s 139B(1)(b) of the National Law) (J [126]-[127]); and in the case of complaint 4, by reason of his conduct being unethical (s 139B(1)(l) of the National Law): J [137], [141(11)]."

1. The HCCC emphasised the seriousness of the conduct of the Respondent in all of the Complaints found to have been established in the Stage One hearing. In relation to Complaint Four the HCCC submitted: "The conduct the subject of complaint 4 was (if proved to the criminal standard) capable of constituting an offence under s 98(1) of the Health Care Complaints Act 1993 (NSW), which reinforces its seriousness (as set out in the Commission's written submissions for stage 1 at [29]-[30], [40])."
2. The HCCC summarised the findings at Stage One as:

"[T]he Respondent's conduct as found by the Tribunal demonstrates serious deficiencies across a range of areas of his knowledge, skill, care and judgment. Members of the public are entitled to have confidence that their treating practitioners will exercise appropriate levels of care and skill; that they will recognise when they have insufficient skills and experience and take appropriate steps to refer the patient to a practitioner who does; that they will keep records that allow for continuity in the patient's care; that they will take care in using scarce public resources; and that they will behave ethically. It is necessary for the Tribunal to send a strong message to the profession and the public that the Respondent's deficiencies in these areas are wholly unacceptable."

1. The submission of the HCCC then addressed what it described as a significant prior regulatory history. It submitted the Respondent:

"[H]as been the subject of at least 13 previous complaints between 1998 and 2021. These include complaints relating to the Respondent's clinical competence, diagnostic ability, communication with patients and integrity as a medical practitioner. One of those complaints (relating to the prescribing of drugs of addiction) resulted in a finding of professional misconduct by the Tribunal in May 2016, a three-month suspension and conditions being imposed on his registration including supervision and audit conditions.

This history is, by itself, a reason for the Tribunal to exercise caution in concluding that the Respondent has reformed his behaviour such that he is now a safe and ethical practitioner."

(omitting footnotes)

1. The HCCC then addressed recent evidence in relation to the Respondent and stated: "[W]hile the Respondent has made positive progress in addressing deficiencies in his knowledge, skill, care and judgment, there are reasons - in addition to his adverse regulatory history - for the Tribunal to remain guarded as to the need to protect members of the public from the Respondent's conduct in the future."
2. It also submitted:

"[W]hile the Respondent has demonstrated some insight into the conduct the subject of these complaints, aspects of that insight are very recent. In particular, before his stage 2 statement dated 4 March 2025, the Respondent:

(a) denied the conduct the subject of complaints 1 to 3 was sufficiently serious to justify the suspension or cancellation of his registration; and

(b) was vehement in his denials that he had offered $1,000 to Patient C to withdraw his complaint to the Commission, and sought to cast doubt on Patient C's account by painting him as someone who was out to extract money from the Respondent. This attempt to undermine Patient C's account, rather than engaging in a searching self-reflection on the basis that Patient C's account was true, is not to the Respondent's credit when it comes to assessing his insight."

1. The HCCC also seeks an order that its costs be paid by the Respondent. It submitted:

"The Tribunal has the power to make such orders in relation to costs as it considers appropriate. The usual principle is that costs follow the event. The Commission was wholly successful at stage 1, including in relation to the disputed complaints, and has otherwise conducted itself in a proper manner such that there is no reason why this usual order should not be made."

(omitting footnotes)

1. The Respondent commenced his submission by accepting the HCCC submission in respect to: "The summary of the Tribunal's findings (Applicant submissions at [11)" and "the principles to be applied in determining appropriate protective orders (Applicant submissions at [3]-[8]."
2. The Respondent disputes the necessity for a suspension or cancellation of his registration as appropriate protective orders. We note that submission was added to in the oral submission of the Respondent after discussion with the Tribunal during the hearing. The Respondent submitted the appropriate protective order would include:

"1) A further period of Category C supervision

2. Complete the ethics course within a specified period of time

3. Not perform skin cancer flap surgery until he has completed the Skin Cancer College of Australasia training in flap surgery (except those flaps required to complete the course)."

"The appropriate protective order is one that does not result in 'more serious consequences for the practitioner than is reasonably necessary in execution of the protective purpose of the legislation': Health Care Complaints Commission v Schmaman [2019] NSWCATOD 82 at [88] citing NSW Bar Association v Meakes [2006] NSWCA 340 at [114]."

1. The Respondent then addressed matters relevant to the principles to be applied by the Tribunal to this Stage Two hearing and the imposition of protective orders. As the Respondent has agreed with the HCCC submission on principle we do not repeat this submission of the Respondent other than to set out the quoted portions of decided cases as follows:

"9. The "task" undertaken by a Tribunal in making protective orders has been described as "[centring] not on punishment as such but on the protection of the public and the maintenance of proper professional standards" (Lee v HCCC [2012] NSWCA 80 (Lee) per Barrett JA at [21]).

10. In Lee, Barrett JA adopted (at [20]) his Honour's observations in Director General, Department of Ageing, Disability and Home Care v Lambert [2009] NSWCA 102; (2009) 74 NSWLR 523 (Lambert) at [83] that:

'1. The specific purpose for which orders are made is protective in the public interest and is not punitive with respect to the individual.

2. That is not to deny that such orders may be punitive in effect and that punitive effect may be relevant in formulating a protective order.

3. The punitive effects may be directly relevant to the need for protection so that, in a particular case, there may be a factual finding that the harrowing experience of disciplinary proceedings, together with the real threat of loss of a livelihood, may have opened the eyes of the individual concerned to the seriousness of his or her conduct so as to diminish significantly the likelihood of its repetition and to produce a level of insight into his or her own character or misconduct which did not previously exist.'

11. Basten JA in Lambert (at [83]) observed that such findings that the punitive effects have reduced the likelihood of the repetition of the misconduct often:

'will be accompanied by a finding that the person concerned has achieved a level of insight into his or her own character or misconduct, which did not previously exist.'

12. As to the setting of a period of prohibiting an application for re-registration, the Tribunal in Health Care Complaints Commission v Luque [2019] NSWCATOD 129 noted that (at [94]):

'The setting of a non-review period is not to punish the practitioner but to protect the public. NSW Court of Appeal jurisprudence has indicated that the fixing of a period of non-review has a 'twofold operation' in that it firstly indicates a minimum period within which the Tribunal considers the person should not be able to practise their profession, thus serving both an individual and general deterrence purpose by sending a message to the practitioner, the public and the profession about professional standards and the seriousness of the breach; and secondly it holds open to the practitioner the possibility of return to the profession at a later time: Chen v HCCC [2017] NSWCA 186; HCCC v Do [2014] NSWCA 307.'"

1. The Respondent then addressed the proposed protective orders which the Tribunal might consider making. The Respondent listed the acknowledgment of deficiency in knowledge which the Respondent addressed in his written statement.
2. In relation to insight and gaps in his knowledge the Respondent submitted:

"At both the oral hearing and in written submissions, the Respondent has demonstrated insight into the degree to which he departed from accepted standards with regard to deficiencies in his knowledge.

Further he has expressed genuine remorse as to the way in which his deficiencies impacted on his patients, particularly Patient C (Respondent Stage 2 statement at [4], final bullet point)."

1. The Respondent addressed what he has undertaken in the way of additional education to fill the gaps in his knowledge. We have seen that evidence attached to his statement in this hearing.
2. The Respondent also referred to the Performance Assessment Report included in exhibit R1. Additionally, the supervision reports in evidence were cited for our benefit.
3. The Respondent then addressed Complaint Four findings. The Tribunal regards that finding as a very significant and troubling matter to be considered in this Stage Two hearing. The Respondent's submission is:

"21. In his supplementary statement at [15] the Respondent candidly addresses the finding made against him that he had offered Patient C money to withdraw his complaint. He explains that while he has no recollection of it, he accepts the finding made against him and can only suggest it was made in a 'moment of sheer panic' and that:

'Such an offer was completely inappropriate and unacceptable. It goes against everything that a medical practitioner should do. For that, I am truly sorry and most embarrassed.'

22. The Respondent has undertaken ethics training. Those courses have provided insight into the professionally boundaries he ought to maintain and the innate power imbalance in the doctor/patient relationship (Respondent Stage Two Statement at [10]).

23. To complement those learnings, he has enrolled in the course entitled 'Clinical Ethics' conducted by the University of Sydney. The course is a post-graduate course which commenced on 25 February 2025 and runs for thirteen weeks."

1. The submission then draws attention to the references provided to the Respondent as we have earlier referred to.
2. The Respondent concludes his written submission with the following:

"26. The Respondent has accepted the findings of the Tribunal and embraces the opportunity to learn from his mistakes and poor decision making (see Respondent Stage 2 statement, 4 March 2025).

The Respondent has much to offer the community after the completion of these proceedings and any period away from practice will adversely impact that. So much is clear from the statement of his former supervisor, Dr Michael Liang, who writes (Respondent Stage 2 Bundle, p 50):

Dr Suri is well liked by his many long-term patients at this medical centre, who continue to see him for a whole range of complex and chronic medical conditions including mental health issues. I know Dr Suri is devoted to his patients and willing to spend extra time to care for his patient, as evidenced by him often staying back several hours at work past his planned finish time. While noting the serious nature of tribunal finding, I think it will be a great loss to many of these patients and the community if Dr Suri was not allowed to continue to practice and service them."

1. In the brief oral submission of the HCCC we note the following in particular:

(1) The establishment of Complaint Four elevates the bar of seriousness in the professional misconduct of the Respondent because the conduct could also have given rise to a criminal prosecution under the National Law.

(2) The Respondent is a practitioner of 30 years standing. He has a significant adverse regulatory history.

(3) At the same time as the Respondent was treating Patient C, he was the subject of a supervision order including record keeping audits.

(4) The Tribunal could not be satisfied about the future conduct of this practitioner if he is permitted to practise.

(5) Although the Tribunal can take into account a recent professional performance assessment, it will note it was not entirely satisfactory, and it was not a practise-based assessment.

(6) There have been no recent patient complaints about the Respondent. Even though he has continued to undertake invasive procedures, he still passed the assessment.

(7) In regard to the complaints referred to in the Stage One proceeding as being "other complaints" not the subject of this proceeding, it is conceded most were considered not to require any action.

(8) It is noted by the HCCC that the Respondent has acknowledged his shortcomings and thereby demonstrates some insight into his conduct the subject of this proceeding. He has undertaken some courses and is undertaking an ethics course. He has expressed regret about approaching Patient C. However, the HCCC submits the Tribunal would not lose sight of the fact the Respondent contested Complaint Four, the professional misconduct complaint. He absolutely denied offering Patient C $1,000 to discontinue his complaint to the HCCC. His insight appears to be only recently obtained.

(9) Although it is conceded to be a genuine mistake on the part of the Respondent, he has failed to comply with the conditions imposed on his registration since early 2024. It was his responsibility to ensure he was practising within his conditions.

(10) If the Tribunal is minded to impose a period of suspension rather than the cancellation order sought by the HCCC then the HCCC submits a period of 12 months would be appropriate.

1. The Respondent informed the Tribunal that he accepts a period of suspension is open to the Tribunal to impose. He submits a period of 3 to 6 months' suspension would satisfy the requirements for deterrence and for the public confidence in the profession.

Conditions to be imposed in the event the Tribunal was to suspend the Respondent's registration rather than to cancel his registration.

1. At the conclusion of the hearing, the Tribunal made directions which required the HCCC to provide, if it so chose, a proposal for conditions in the event of a suspension order being made. The Respondent was to provide his response to such proposal.
2. The HCCC helpfully provided the following proposal for conditions.

"APPLICANT'S DRAFT CONDITIONS

1. To forward evidence to the Medical Council of NSW within 14 days of this decision, that the practitioner has provided a copy of the stage 1 and 2 decisions including these conditions, to his current employer/owner/principal of the practice.

2. To advise the Medical Council of NSW in writing at least seven days prior to changing the nature or place of the practitioner's practice.

3. To practise only in a group practice approved by the Medical Council of NSW of at least 2 other registered medical practitioners, and:

a. Where the patients and patient records are shared between the medical practitioners:

b. Where there is always one other registered medical practitioner on site.

4. Not to undertake any invasive skin procedures for either diagnostic or therapeutic purposes with the exception of:

a. 30061 - superficial foreign body, removal of

b. 30029 - skin and subcutaneous tissue or mucous membrane, repair of wound

c. 30192 - cryotherapy.

5. Audit - the practitioner shall submit to an audit of his medical records by a random selection of his medical records by a person or persons nominated by the Council: and

a. the audit is to be within 6 months of the practitioner recommencing practice;

b. the practitioner is to authorise the auditor to provide the Council with a report of their findings; and

c. the practitioner is to meet all costs associated with the audit and any audit report.

a. The practitioner shall nominate a supervisor prior to recommencing practice to be approved by the Council, to monitor and review his clinical practice in accordance with the Council's Compliance Policy - Supervision

b. The supervisor is to be provided with a copy of the Council's Compliance Policy and a copy of the Tribunal's decision;

c. The cost of the supervision is to be borne by the practitioner;

d. The practitioner and the supervisor are to meet on a fortnightly basis for at least one hour

e. At each meeting, the practitioner and the supervisor are to address the matters highlighted as concerns in the Tribunal's decision as well as issues arising from his recommencement of practice after any period of suspension

f. At each meeting the supervisor is required to complete a record of matters discussed in a form approved by the Council;

g. The practitioner is to authorise the supervisor to forward supervision reports to the Council on a three monthly basis in a format approved by the Council;

h. The supervisor is to inform the Council immediately is there is any concern in relation to the practitioner's compliance with the supervision requirements, other conditions of registration, clinical performance or if the supervisor relationship ceases;

i. The requirements of Category C supervision as set out in the Council's Compliance Policy (Supervision) apply. However, where this condition varies that policy, this condition prevails.

j. The practitioner is to meet all costs associated with this condition.

7. The Medical Council of NSW is the appropriate review body for the purposes of Division 8, Part 8 of the Health Practitioner Regulation National Law (NSW)."

1. On 24 March 2025 the Registrar received an email from the Respondent's solicitor which included the following statement:

"In accordance with Order 3 of the Orders made by the Tribunal on 12 March last, I am instructed the respondent will not provide any further material in response to the document of the Applicant. In short, the Respondent accepts that subject to the Tribunal's consideration of the proposed Conditions those are appropriate."

Determination of the Protective orders to be applied.

1. We have considered all the evidence and submissions provided in this Stage Two hearing, including our determination at Stage One. We have determined that the appropriate protective order to impose is a suspension of the Respondent's registration for a period of six months and the imposition of conditions on his registration upon his resumption of practise at the conclusion of the period of suspension. In so deciding, the most significant matters which have given rise to that conclusion have been as follows:

(1) In relation to the intrinsic seriousness of the misconduct, in terms of fitness to practise, we have been very troubled by the Respondent's conduct in making contact with Patient C after the receipt of correspondence from the HCCC notifying him of the complaint made by both Patient C and another practitioner in the Respondent's practice. It is clear on the evidence that the Respondent made contact with Patient C and made an arrangement to meet with him, out of his practice rooms, with the aim of persuading Patient C to withdraw his complaint. That conduct was compounded in seriousness when the Respondent offered Patient C, effectively a bribe (couched as compensation) to not proceed with the complaint. That conduct was prima facie, on its own, deserving of an order for cancellation. It raised real concern as to the integrity of the Respondent.

(2) For the reasons which appear hereafter we have decided that a period of suspension coupled with conditions will secure the safety of the public and the confidence to know that the regulatory bodies are appropriately overseeing the medical profession in the conduct of their work.

(3) The conduct which has given rise to the complaints we have heard arose as a result of the Respondent practising skin cancer medicine. He did so at a time when he was deficient in the necessary knowledge to conduct that type of practice. He has since gained further education in relation to skin medicine. He is prepared to restrict his practice in that area to defined and limited procedures which involve incisions or other forms of invasive techniques relating to skin.

(4) We have not heard any complaint about the balance of the work the Respondent has undertaken and continues to undertake with his patients. About half of his work now is in the area of geriatrics and mental health.

(5) The Respondent is 64 years of age and will probably only practise for another seven years before retirement.

(6) The imposition of protective orders focusses primarily on the safety of the public and the protection of that public from incompetent and inappropriate practitioners. That protection extends beyond actual medical work and extends to the appropriateness of relationships between practitioners and their clients. It also requires practitioners to be suitably trained and qualified to practise in a competent and ethical manner.

(7) We consider that the ethical misconduct exhibited by the Respondent with Patient C is capable of being seen as an isolated episode. We have had regard to the references provided by the persons nominated by the Respondent and included in exhibit R1. Those referees spoke glowingly of the Respondent's personality as they know him.

(8) In relation to the conduct of the Respondent in meeting with Patient C and offering him a payment to withdraw his complaint, we do accept that conduct was motivated by panic on the part of the Respondent without due regard to the consequences if it was refused by Patient C or detected and referred to the HCCC in the form of a complaint. The Respondent had quite a lengthy complaint history at that time including a period of suspension having faced the Tribunal. He must have been aware of the serious possibility of losing his right to practise if the complaint of Patient C was elevated to another hearing before the Tribunal.

(9) We are satisfied we can control the nature of the skin medicine the Respondent can practise by the imposition of conditions which will then be the subject of oversight by the Medical Council.

(10) We are satisfied the Respondent does have the skill and experience to function well as a medical practitioner specialist GP, in areas of general medicine, geriatrics and mental health medicine. We are of the opinion that the Respondent should abandon his desire to progress further into the area of skin medicine to the extent that requires him to undertake invasive skin procedures.

(11) The imposition of a suspension and restrictive conditions does have a deterrent impact both specifically to the Respondent and generally to the medical profession. This judgment will be published to the world at large and experience shows the details of this case may well be published further in profession specific publications and in the general press. Such publications will enhance the deterrent impact of this decision. It will also illustrate the regulatory control of the profession and raise the confidence of the public in the profession.

(12) This judgment has raised again the importance the Tribunal sees in the obtaining of informed consent from patients prior to conducting any treatment of them. That is particularly so with any procedure which involves the cutting of skin. Patients are entitled to know what alternatives are available. They need to know what the possible outcomes will be not only in relation to future diagnosis but also in relation to the resulting appearance of the skin area subjected to the procedure. Managing patient expectations is a very important aspect of obtaining informed consent.

(13) Although it was not the subject of a separate complaint in this case, we know the Respondent was required to repay some Medicare payments which were wrongly made. The evidence established that there are a significant number of different Medicare claim numbers which apply to the type of lesions removal and biopsies of suspected irregularities or disease in skin. The raising of those concerns in this matter will highlight for the Respondent the care which needs to be undertaken in Medicare claims made by a medical professional.

(14) Protective orders are not to be formulated to meet an aim to punish the practitioner for his/her professional misconduct. They are to ensure the safety of the public as the primary function.

(15) The loss of a medical practitioner who is competent to practise has a potential adverse impact on the public at large in that it limits the availability of that practitioner to attend to the public's medical requirements.

Conditions to be imposed on the Respondent's registration

1. We have considered all the conditions proposed by the HCCC. We note none of those conditions is opposed by the Respondent. We conclude that all those conditions are appropriate and we will make an order requiring the imposition of those conditions on the Respondent's registration to operate upon his resuming practice at the conclusion of the suspension period of six months.

1. The HCCC seeks an order that the Respondent pay its costs of the proceeding as agreed or as assessed. The Respondent has provided no submission against the making of such an order. We propose to make the order sought by the HCCC.
2. For the sake of clarity, we are satisfied that this is a case which requires the imposition of the costs order as sought by the HCCC. There is nothing about the conduct of the HCCC in this proceeding or any other apparent reason to depart from the usual practice of awarding costs following the outcome of the proceeding to a party who has been wholly successful. In this proceeding the HCCC has been wholly successful at Stage One and although seeking a cancellation order in Stage Two and not obtaining that from the Tribunal, they have been successful in convincing the Tribunal the order for a Caution or Reprimand, as sought by the Respondent, was not appropriate.

(1) The Respondent's registration is suspended for a period of six months from the date of this order.

(2) At the conclusion of the suspension period the following conditions are to apply to the Respondent's registration.

(a) To forward evidence to the Medical Council of NSW within 14 days of this decision, that the practitioner has provided a copy of the Stage 1 and 2 decisions including these conditions, to his current employer/owner/principal of the practice.

(b) To advise the Medical Council of NSW in writing at least seven days prior to changing the nature or place of the practitioner's practice.

(c) To practise only in a group practice approved by the Medical Council of NSW of at least 2 other registered medical practitioners, and:

(i) Where the patients and patient records are shared between the medical practitioners;

(ii) Where there is always one other registered medical practitioner on site.

(d) Not to undertake any invasive skin procedures for either diagnostic or therapeutic purposes with the exception of:

(i) 30061 - superficial foreign body, removal of;

(ii) 30029 - skin and subcutaneous tissue or mucous membrane, repair of wound;

(iii) 30192 - cryotherapy.

(e) Audit - the practitioner shall submit to an audit of his medical records by a random selection of his medical records by a person or persons nominated by the Council: and

(i) the audit is to be within 6 months of the practitioner recommencing practice;

(ii) the practitioner is to authorise the auditor to provide the Council with a report of their findings; and

(iii) the practitioner is to meet all costs associated with the audit and any audit report.

(f) Supervision:

(i) The practitioner shall nominate a supervisor prior to recommencing practice to be approved by the Council, to monitor and review his clinical practice in accordance with the Council's Compliance Policy - Supervision;

(ii) The supervisor is to be provided with a copy of the Council's Compliance Policy and a copy of the Tribunal's decision;

(iii) The cost of the supervision is to be borne by the practitioner;

(iv) The practitioner and the supervisor are to meet on a fortnightly basis for at least one hour;

(v) At each meeting, the practitioner and the supervisor are to address the matters highlighted as concerns in the Tribunal's decision as well as issues arising from his recommencement of practice after any period of suspension;

(vi) At each meeting the supervisor is required to complete a record of matters discussed in a form approved by the Council;

(vii) The practitioner is to authorise the supervisor to forward supervision reports to the Council on a three monthly basis in a format approved by the Council;

(viii) The supervisor is to inform the Council immediately if there is any concern in relation to the practitioner's compliance with the supervision requirements, other conditions of registration, clinical performance or if the supervisor relationship ceases;

(ix) The requirements of Category C supervision as set out in the Council's Compliance Policy (Supervision) apply. However, where this condition varies that policy, this condition prevails;

(x) The practitioner is to meet all costs associated with this condition.

(g) The Medical Council of NSW is the appropriate review body for the purposes of Division 8, Part 8 of the Health Practitioner Regulation National Law (NSW).

(3) The Respondent is to pay the costs of the HCCC as agreed or as assessed.

(4) Pursuant to s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW), the disclosure of the name of any patient referred to in the proceeding is prohibited.

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.