55 Dr Michael Ooi stated that every year he has appointed a certain number of registrars who commenced work in their 3rd post graduate year.
Dr Vincent Varjavandi's
56 The applicant called Dr Vincent Varjavandi, a staff specialist in paediatrics surgery at the Sydney Children's Hospital in Randwick, to give evidence about the role of Registrar in contrast with the role of RMO. He gave the following evidence in examination-in-chief:
Q: Are you able to describe to the Court, as you see it, the role of the Registrar in contrast with the role of the Resident Medical Officer?
A: In the surgical field, this is throughout all specialities, it's a quantum leap in the transition from Resident to Registrar, they act completely different in terms of what they are expected to do. If we start with the Resident...
...
It's very much a bookkeeping thing. So they're writing notes and they look at the patients on the ward, so it's basically writing charts and sorting out medications. The job of a Registrar, as I say, it's a real step in seniority. So their main role - the biggest difference is they deal with the patients who present to the Emergency Department, and this is across all things, so they will deal for [sic] the abdominal pains, and this is surgery, to the multiple traumas section.
Their prime job is to decide who is sick, who needs to be admitted to hospital for an operation and who is not sick. It's an incredible responsibility. That's a life or death front line job and that's the Registrar's job...They also do operations after hours and that is often independently.
...
Q: When you say "a Registrar operating independently", independently from whom?
A: From a consultant. There is always a consultant on-call. When they decide this patient needs to go to theatre, they call the consultant who's on-call who says "I agree", the consultant will say, "are you happy to do that?" If it's a simple procedure they will do that in the operating room independently. It's a huge responsibility.
...
Q: Are you able to identify any other differences between the role of the Resident and the Registrar?
A: The main difference is who they liaise with, who they report to, if you like. Residents, their job is to report to the Registrars. So they will deal with problems on the ward, if they have something they can't handle, they speak to the Registrar.
The job of the Registrar is they very much are in direct liaison to the consultant, they continue being in contact with the consultant discussing patient management.
Respondent's evidence
57 Mr Trevor Craft is the Deputy Director, Workplace Relations and Management in the NSW Department of Health. He is responsible for managing the development, implementation and evaluation of industrial relations policy and workplace reforms affecting employees and other participants in the New South Wales public health system. Mr Craft has occupied Senior Executive Service positions in the NSW Department of Health dealing with industrial relations, employee relations and workplace relations since November 2000.
58 Mr Gotting read a statement of Dr Craft dated 14 April 2010. Relevantly, Mr Craft stated that, "I understand and am of the view that it is possible to perform the duties of Registrar but not have the title (or be appointed to the position) of Registrar." In his statement, Mr Craft outlined the history of the relevant Award, the definition of Registrar and the application of the Award definition of Registrar. He then dealt with each of the doctors involved in these proceedings. He determined that there were no exceptional circumstances relating to the appointments of each of the nine doctors to justify a reclassification of their positions as Registrar.
59 Mr Craft was cross-examined by Mr Murphy on the way in which he determined applications made by doctors seeking to be re-classified as Registrars. Mr Murphy submitted that it was accepted by Mr Craft that the respondent has no policy which deals with the determination of whether or not a period of less than three years experience is acceptable. Relevantly, Mr Craft gave the following evidence:
Q: Is there any issue [with] the Department of Health policy dealing with the determination of whether or not a period of less than three years is acceptable to the department for persons reclassified as a Registrar?
A: I don't believe there is a policy on that point.
Q: So when you're conducting the determination we are talking about, the acceptability of the lesser period, you do not have an issue the Department of Health policy to consistent [sic] you in that determination, is that the case?
A: I do have the Department of Health policy in respect of Resident Medical Officers, that forms part of the suite [sic] of assistance and policies behind that determining or deciding the power.
Q: You don't have an issue with the Department of Health policy on the responsibility and duties of a Registrar, do you?
A: No I don't.
60 Mr Murphy further submitted that there are no guidelines to assist in the consideration of whether or not a lesser period is deemed appropriate. In cross-examination, Mr Craft gave the following evidence:
Q: In your researches, or those you directed occur, were you able to find whether or not at or after this time there were any guidelines promulgated which would assist someone to consider whether or not a lesser period was deemed appropriate?
A: My understanding is there are no guidelines of the nature you have postulated.
61 Mr Murphy submitted that it was accepted by Mr Craft that the doctors in these proceedings would have discharged the functions and activities of a Registrar as described by Justice Kelleher in 1974, and that a delegate making a decision may only give consideration to matters that are relevant.
62 In terms of the consideration of day to day duties and responsibilities of the doctors in determining their applications, Mr Craft gave the following evidence:
Q: When you make a determination whether a lesser period than three years is acceptable to the Department, one of the things you give serious consideration to is the role - I mean the actual day to day duties performed by, and the responsibilities on and accepted by these individuals, you examine what they do?
A: That is one of the considerations yes it is.
Q: It is an important consideration is it not?
A: It is an important consideration.
...
Q: When the person who has the task of deeming whether the lesser period is appropriate is performing that task, you would accept it would only be properly performed by taking into account matters that were relevant to the role of a Registrar?
A: That would be a consideration yes.
63 Mr Craft included in his statement a list of comparative cases where applications had been made to the respondent concerning the appropriate classification of medical officers, and in particular seeking re-classification of medical officers to Registrar positions. Mr Craft provided details of approximately 30 cases where approval had been granted. However, an analysis of the circumstances of the successful applications shows that approval was granted in circumstances where the doctor was the sole applicant for the Registrar role, where the doctor was close to the requisite three years' experience such as Dr McNamara who had two years and seven months of public hospital experience, and circumstances where there was a shortage of Registrars in a particular department. The applications that were refused were refused on the basis that there were no exceptional circumstances warranting dispensation from the Award requirement for Registrars of three years' experience. When dealing with the circumstances of the doctors involved in these proceedings, Mr Craft concluded that there were no exceptional circumstances in each of the cases. Relevantly, in cross-examination, Mr Craft gave the following evidence:
Q: The provision simply provides for three years experience or any lesser period accepted to the Department of Health?
A: Yes it does.
Q: So a lesser period, the less than three years, has to be acceptable to the Department of Health that's the qualification?
A: Correct.
Q: There is no additional gloss in the nature of "and you will only be approved in exceptional circumstances". That does not appear, does it?
A: Not in those words, no.