63 In the fourth place, allowing that the effect of a finding pursuant under s 43(1)(b) of the Act depends on the proper construction of the Act, and putting aside for the moment the effect of s 25(7), it appears to me that there are at least just as good reasons to conclude that the Board may not revisit such a finding as there were to conclude that the several decisions dealt with in the cases I have mentioned could not be re-opened.
The construction of Part 3 of the Act
64 I start with the general proposition enunciated in Bhardwaj that the requirements of good administration and the need for people affected directly or indirectly by decisions to know where they stand mean that finality is more often than not the paramount consideration. It is similar to the principles of public policy which are said to be encapsulated in the maxims nemo debet bis vexari, si constat curiae quod sit pro una et eadem causa [31] and interest reipublicae ut sit finis litium.[32] More particularly, however, to borrow from the language of Vaisey, J in Re 56 Denton Road, Twickenham, it would introduce a lamentable measure of uncertainty and so much disturbance in the minds of those unfortunate persons who have cause to complain of, or are the subject of complaint of, unprofessional conduct in the practice of medicine that the Act cannot have contemplated the possibility of such vacillations as are claimed to be permissible in such a case as the present.
65 Secondly, one may ask rhetorically where would the exercise stop if it were possible for the Board to re-open the findings of an informal hearing. If a finding might be re-opened once, then why not twice and, if twice, why not as many times as the Board determined to be appropriate (always assuming bona fides and, objectively speaking, a good reason to re-open)? In principle, there would be nothing in the way of the Board re-opening a finding on multiple occasions and for years after the events in issue.
66 Perhaps recognising the problems to which that consideration gives rise, counsel for the Board submitted that any excesses in the exercise of power to re-open the findings of an informal hearing could in an appropriate case be prevented by application for a stay of further hearing as an abuse of process. But that is not an answer to the problem. If the effect of the Act were that the Board had capacity to re-open a finding for good reason whenever and for so long as it chose, there would be no abuse of process in exercising the power for good reason whenever and for so long as it chose. Surely, the better view is that there must be a terminus and, by parity of reasoning with the analysis of Grove, J. in Walter Construction Group Limited v Fair Trading Administration Corporation, the logical place for it is the finding and determination which results from the first informal hearing.
67 Thirdly, s 45 of the Act provides that upon completion of an informal hearing the medical practitioner the subject of hearing may request that a formal hearing be held to review any findings and determinations of the informal hearing. There is, however, no corresponding provision for the Board of its own motion to convene a formal hearing to review the findings and determinations of the informal hearing. Indeed, to the contrary, s 44 of the Act implies that once the Board has determined on the path of an informal hearing it is bound by its election unless before the completion of the informal hearing it abandons the informal hearing and refers the matter to a formal hearing. Like the Professional Standards Act considered in Ping v Medical Board of Queensland, the Act appears to require the Board to decide or elect to proceed by way of informal hearing or, before the completion of the informal hearing, to refer the matter to a formal hearing and that, having elected to go down the path of an informal hearing and not arresting the process before the completion of the hearing, the Board is bound by the result.
68 Granted, it does not necessarily follow from the fact that the Board is powerless to refer the findings and determinations of an informal hearing to a formal hearing that the Board is powerless to refer the findings and determination of an informal hearing to another informal hearing. But logic and common sense tend to suggest that it was not what Parliament intended.
69 Fourthly, as was conceded by the Board, if the Board had power to refer the matter to a second informal hearing, it is at least possible that the second informal hearing would reach findings that are inconsistent with the findings of the first informal hearing and make determinations that are additional or different to those of first informal hearing. Since, however, a statutory tribunal has only those powers which are expressly conferred upon it by statute or which are necessarily incidental thereto, the second or subsequent informal hearing would lack the capacity to set aside the findings and determinations of the first informal hearing. Hence, there may be two sets of inconsistent findings and perhaps determinations and, if the Board is right, and the power to conduct further informal hearings is capable of being exercised from time to time, there might be no end to the number of times that a further informal hearing could add to the pile of inconsistencies. I am unable to accept that Parliament intended to create that state of affairs in the regulation of the medical profession.
70 In face of the difficulties to which those problems give rise, counsel for the Board submitted that a distinction should be drawn between a case like the present in which there has been a finding that the practitioner has not engaged in unprofessional conduct (which the Board contends would not have any legal consequences), and a case in which there is a finding that the practitioner has engaged in unprofessional conduct (which the Board concedes would or may have legal consequences). In the Board's submission, there is no reason why the Board should not order a second informal hearing in the first type of case even if it is to be concluded that the possibility of inconsistency means that it could not do so in the second type of case.
71 I do not find that submission persuasive either. The notion that a favourable finding is without legal effect is facile. It leaves out of account the effect on practitioner's professional standing and the appointments which might be opened or foreclosed to him or her according to his or her professional standing. If a favourable finding can be replaced with a later unfavourable finding, it means that any practitioner who has undergone a favourable informal hearing is forever tarred with the brush of suspicion that the finding may one day be reversed. It also leaves out of account the effect on the practitioner's professional indemnity arrangements; and it is to be noted that they would not necessarily be limited to the practitioner. For quite apart from the level of premiums which a practitioner may be required to pay once it is perceived that a finding is capable of being re-opened at any time, it is not difficult to suppose that some underwriters could seek to deny or reduce liability on the basis that the risk was written in ignorance of the unprofessional conduct later disclosed by the finding of the second hearing.
72 The notion that a favourable finding is without legal effect also leaves out of account the effect on innocent third parties. In the scheme of things, they could well be public or charitable institutions that have appointed a practitioner or entered into some other form of professional arrangement with the practitioner on the faith of a favourable finding and are later faced with a contrary finding from a second or subsequent hearing. It raises the spectre of arrangements of that kind being re-opened, possibly years after the event, on the basis that a previous favourable finding is later replaced by one which is unfavourable. It opens to question whether such appointors might be liable to others for having selected a practitioner who, as the results of the second hearing disclose, had engaged in unprofessional conduct.
73 Moreover, and perhaps more importantly, if it were right that the Board had power to conduct a further hearing in a case where the finding of the first hearing was favourable to the practitioner, there is no discernable basis to conclude that it would not also have the power to conduct a further hearing in a case where the finding was adverse to the practitioner. Potentially, therefore, arrangements, including arrangements for the compensation of persons for the effects of treatment ruled to have been unprofessional, would be open to be reversed when later it was found by a second or subsequent hearing that the treatment had not been unprofessional. As Kirby, J. put it in the different context of Bhardwaj:[33]