1. VCAT finds:
   • (a) With respect to Allegations 1 to 11, 13 and 14 in this proceeding the respondent behaved in a way which constitutes professional misconduct as defined in paragraph (b) of 5 of the Health Practitioner Regulation National Law Act 2009 (Vic) (the National Law). Multiple instances of unprofessional conduct, considered together, amount to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience;
   • (b) With respect to Allegation 15 in this proceeding, the respondent behaved in a way which constitutes professional misconduct as defined in paragraph (a) of 5 of the National Law. His unprofessional conduct amounted to conduct substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience.

1. VCAT makes the following determinations under s 196 of the National Law.
2. Dr P is reprimanded.
3. The following conditions are imposed on the registration of Dr P as a medical practitioner:
   • (a) He is not to prescribe or administer Schedule 8 drugs.
   • (b) He is not to possess or self-administer Schedule 8 drugs or Schedule 4 drugs of dependence unless prescribed for him by his treating practitioners and where this occurs, evidence of the prescription is to be provided to the Board within seven days of the issuing of the prescription.
   • (c) On the same day Dr P commences employment as a medical practitioner, whether as a locum practitioner or otherwise, he will attend for and undergo urine drug screening and for the time that he remains employed as a medical practitioner, he will undergo random urine drug screening in accordance with the Board's protocol in force at the date these conditions are imposed, and then as amended from time to time, unless otherwise provided in these conditions and he will meet the Board's specific requirements in relation to this:
     • (i) To contact AHPRA on the day he commences employment to confirm he has undertaken urine drug screening and will commence to do so thereafter in accordance with the Board's protocol;
     • (ii) When Dr P ceases employment as a medical practitioner, he may cease urine drug screening until such time as this condition is next relevant;
     • (iii) He is not to continue to work as a medical practitioner if he fails to provide a supervised urine drug screen when required, until after such time as he presents for and undergoes the urine drug screening;
     • (iv) To authorise the testing laboratory performing the drug screening and AHPRA to communicate about the results of the drug screening;
     • (v) To authorise AHPRA to communicate about the results of the urine drug screening with his treating practitioners and obtain inputs from his treating practitioners regarding the interpretation of the results; and
     • (vi) The urine drug screens are to test for the following drug classes: benzodiazepines, cannabis metabolites, cocaine metabolites, opiates, amphetamine type substances, and pethidine.
   • (d) Upon return to practice, to attend for hair analysis every three months in accordance with the Board's protocol in force at the date these conditions are imposed and then as amended from time to time unless otherwise provided in these conditions and to meet the Board's specific requirements in relation to this:
     • (i) The hair analysis is to test for the following drug classes: pethidine, opiates and fentanyl.
     • (ii) The Board may also require hair analysis for propofol, as and when required.
   • (e) To attend his treating psychiatrist and general practitioner ('treating practitioners') at his expense for regular sessions at a frequency determined by the treating practitioners, and to meet the Board's specific requirements in relation to this:
     • (i) To provide contact details of the treating practitioners to AHPRA within fourteen days of imposition of this condition;
     • (ii) To authorise the treating practitioners and AHPRA to communicate about his treatment and ongoing fitness to practise;
     • (iii) To authorise AHPRA to release the assessor's report to his treating practitioners;
     • (iv) To provide reports from the treating practitioners to AHPRA every three months (or at the request of AHPRA or the Board);
     • (v) The reports should address Dr P's compliance with treatment directions (including medication regimen, his attendance at scheduled appointments, his ongoing fitness to practise), and whether he requires treatment by an addiction specialist; and
     • (vi) If the Board does not consider the information within these reports demonstrates that Dr P's compliance with this condition is satisfactory, the Board may take further action as necessary.
   • (f) To work in a position approved by the Board and to meet the Board's specific requirements in relation to this:
     • (i) To ensure that the senior practice partner(s) is aware of the conditions on his registration by providing the person with a copy of these conditions and to provide AHPRA with a statement from the appropriate person(s) that a copy of the conditions has been received;
     • (ii) To work with a supervisor approved by the Board;
     • (iii) To ensure that the Board receives a work report from the supervisor every three months, or more frequently if the Board deems this necessary; and
     • (iv) To authorise the senior practice partners, supervisor and AHPRA to communicate about his clinical and work performance and his compliance with the conditions imposed on his registration.
   • (g) To work with the following restrictions:
     • (i) Not to undertake on-call work or work outside the hours of 8 am to 8 pm, Monday to Sunday;

(ii) Not to exceed 40 hours of clinical contact per week;

Not to work unless there is at least one other medical practitioner onsite; and

Not to work in the areas of general and regional anaesthesia (excluding standard local anaesthesia) and sedation for procedures.

1. After 12 months from the date Dr P is next employed as a medical practitioner, on his request, the applicant is to review the above conditions.

1. In December 2015, the Medical Board of Australia (the Board) referred allegations against Dr P to VCAT under the Health Practitioner Regulation National Law (the National Law).[1]
2. Part of the background to this was that at all times between 14 June 2012 and 18 October 2013, Dr P was subject to a condition on his registration that he undergo random urinary drug screening in accordance with a document entitled 'Protocol for Random Urinalysis for Dr [P]'. Dr P was required to call a telephone number every weekday, to obtain instructions on whether he was to attend for testing on that day. If it was a nominated testing day, Dr P was required to attend a testing facility and submit a urine sample for testing.
3. The allegations (apart from Allegation 12 which was later withdrawn) related to him:
   1. On 11 occasions between 3 July 2012 and 4 April 2013 failing to undergo required urinary drug screening, such conduct being either 11 instances of unprofessional conduct or considered together professional misconduct (Allegations 1 to 11 and 14);
   2. On 18 October 2013, Dr P obtained propofol, in breach of a condition on his registration, when at work as an anaesthetist at a Melbourne surgery (the Surgery). A gastroscopy and colonoscopy surgical list was about to commence. He injected himself with the drug, for nonclinical purposes, which he obtained from the Surgery's supplies, then provided clinical services as an anaesthetist. Following the completion of the first procedure, the surgical list was suspended due to concerns that Dr P was unfit to practise (Allegations 13, 14 and 15).
4. Allegation 13 concerned Dr P breaching a condition imposed on his registration by VCAT, which was in force at the time he self-injected, that he was not do so. Allegation 14, that multiple instances of unprofessional conduct amounted to professional misconduct in part relied on Allegation 13. The Board also alleged Dr P had provided to AHPRA medical certificates, or advised he was an annual leave when he had in fact performed, and billed, for clinical services. Allegation 15 was the allegation of substance abuse concerning self-administration of propofol.
5. By the time the allegations came before us for hearing, the Board and Dr P had provided an agreed statement of facts that Dr P had failed to undertake the urine tests and had self-administered propofol as alleged. Dr P and the Board agreed the self-administration amounted to professional misconduct under the National Law.
6. What remained in contention was:

1. Whether the instances of failing to undertake urine tests should be characterised as 11 instances of unprofessional conduct or considered together to amount to professional misconduct; 2. How the 11 instances should be regarded in the light of Dr P's explanations of how each non-compliance occurred; and

1. Concerning new conditions on Dr P's registration as a medical practitioner that we would likely impose, whether: 1. the conditions should explicitly include a condition that he not prescribe or administer propofol, given that another condition would prohibit him from practising anaesthesia; 2. it was appropriate to modify conditions proposed by the Board such that if Dr P received a job offer, the Board would be required to consider whether or not to approve him undertaking that employment on an expedited basis; 3. the extent to which he was to be prohibited from working 'after hours'; 4. whether the conditions should prohibit him from working unless there was at least one other medical practitioner on-site, or as Dr P submitted was appropriate, the requirement should be for a health practitioner, such as a registered nurse, to be on site; and 5. whether the conditions should include that Dr P was required to provide a monthly statutory declaration to AHPRA declaring he had in that month complied with the conditions on his registration.
2. At hearing, we heard evidence from Mr Mark McPherson, Compliance Team Leader, Victorian Office, AHPRA and Dr P, who were cross-examined. Mr McPherson's evidence largely concerned uncontentious issues concerning history prior to this proceeding. We also considered documentary evidence collected into a tribunal book, some of which we discuss below. This includes a report from Dr Enrico Cementon, Consultant Psychiatrist with qualifications in medicine, surgery, general practice, psychiatry and addiction medicine. Dr P did not seek to cross-examine Dr Cementon.
3. We have found Dr P's 11 failures to undergo urine testing to together constitute professional misconduct under the National Law. To that we add his unprofessional conduct in breaching conditions relating to self-injecting and working on days when he, possibly inadvertently, led the board to understand he would not be working. Self-injecting of propofol on its own amounted to professional misconduct conduct. We have imposed conditions on his registration with only minor alteration from those proposed by the Board.
4. In an earlier VCAT proceeding, in December 2012, VCAT determined Dr P had engaged in professional misconduct under s 77(1)(a) of the (now repealed) Health Professions Registration Act 2005. He was reprimanded and cautioned, and conditions were imposed on his registration. VCAT published its 2012 orders and reasons as DRP v Medical Board of Victoria (Occupational and Business Regulation) [2012] VCAT 1904. It adopted the description 'Dr P'. Consistent with that earlier approach, on Dr P's request, we do not here reveal his identity. Our decision published on Austlii, will in the case title referred to him as 'DRP' as the earlier decision did. That said, while in this proceeding the VCAT proceeding file is closed to inspection by all the parties,[2] no order has been made under the Open Courts Act 2013 preventing publication of Dr P's identity.
5. We understand AHPRA will publish a version of the conditions we have imposed which identify Dr P and that AHPRA, as far as is practical, publishes conditions without publishing detail concerning medical practitioners' private personal medical information.

1. Dr P has decades of experience as a medical practitioner in Ireland (where he qualified) in the United Kingdom and in Australia. In Australia this has included work in metropolitan and regional areas as a general practitioner. He developed a specific interest in anaesthesia. He has also worked as a medical educator, in the medical insurance industry. According to his oral evidence at hearing, he last worked with any consistency as a general practitioner in 2002 with some locum work in 2010/2011. He said he has kept current in terms of continuing professional education, such that he is qualified to return to employment in general practice.

1. As the parties agreed, on:
   1. 3 July, 15 August, 3 and 10 September and 7 December 2012 and on 3 and 9 January 2013, and
   2. 7 February 2013, 14 and 25 March 2013 and 4 Apri1 2013;

Dr P was required to submit a urine sample for drug testing

1. On each of those dates Dr P was in Victoria, attended work as a medical practitioner, billed Medicare using his practitioner number for services performed as an anaesthetist, and did not provide a urine sample.

1. Also as the parties agree, on 18 October 2013, Dr P administered propofol, a Schedule 4 drug under the Poisons Standard, as published and in force under s 52D(2)(b) of the Therapeutic Goods Act 1989 (Cth), in breach of condition (ii) on his registration.
2. He was rostered to work at the Surgery as an anaesthetist for a gastroscopy and colonoscopy l list and presented to work at or around 7 am that day;
3. At about 7:20 am, he took, for non-clinical purposes, a syringe containing 10 mls of propofol from the Surgery's supplies. Shortly after, he administered the propofol to himself at the Surgery;
4. At approximately 8:15 am, the endoscopy list commenced. Dr P provided clinical services as an anaesthetist to a patient whilst under the influence of propofol. Following completion of the first procedure, the endoscopy list was suspended due to concerns that Dr P was unfit to practise.

1. The Board received a number of notifications concerning18 October, including one from Dr P.
2. On 31 October 2013, an Immediate Action Committee of the Board suspended Dr P's registration. On 26 November 2013, the Board decided to investigate the events of 18 October 2013. On 8 January 2015, the Board lifted the IAC suspension and imposed new conditions on Dr P's registration. As the Board noted in its letter to Dr P dated 12 January 2015, the January conditions replaced the conditions VCAT had imposed in December 2012. The 8 January conditions remain in force until our orders take effect and replace them.
3. The conditions imposed as a result of this proceeding have much in common with the 8 January conditions. Mr McPherson gave evidence that the main reason for the differences between the January conditions and the conditions the Board proposed in this proceeding was that in the interim the Board had reviewed its approach to drug testing and urine screening and had, concerning Dr P, taken Dr Cementon's recommendations (see below) into account.

1. At the Board's request, Dr Cementon provided an independent expert report in this proceeding. He had provided health assessments concerning Dr P in 2009 and 2014 and so was well-placed to provide his 2016 opinion. While we considered his entire report, in terms of a summary we quote his April 2016 report:

Dr P is now 59 years old and has not practised medicine since the brief lapse of his substance use disorder in October 2013. ...

[He] has several long-term and recurrent health problems. His depressive disorder, which commenced in the 1990s, is stable and appeared somewhat improved at this assessment relative to my last assessment ... in 2014; however it continues to be problematic, in part due to recurrent and persisting personal losses and adverse life events, and I suspect his depression and its associated low motivation and drive and subjective forgetfulness have contributed to his inability to successfully obtain work.

A recent additional problem included the exacerbation of some anxiety symptoms of post­ traumatic stress disorder following his return to the scenes of previous traumatic experiences in the UK.

Dr P's substance use disorder now appears to be in sustained remission in that it has been more than twelve months since his last lapse of drug misuse and associated problems. I note however, that there is no objective evidence to corroborate this history as no laboratory investigations such as urine drug screens have been performed as [he] has not been working in clinical practice.

Although Dr P has only remotely engaged in treatment with the VDHP [Victorian Doctors Health Program] he has continued some substance use treatment by forming a small mutual support group that attends formal mutual help groups.

There have been several musculoskeletal injuries that have necessitated treatment with opioids and other potential drugs of misuse under the direction of other medical practitioners, however this drug exposure does not appear to have triggered any episodes of drug craving or drug misuse.

I believe Dr P is currently fit to practise medicine and indeed, his return to work may alleviate the financial stresses he described to me. Furthermore, the successful return to work is frequently an important part of one's recovery from mental illness such as depression and substance abuse and this may well be the case for Dr P.

As I have indicated in my previous reports, there is a strong relationship between depression, anxiety and substance use disorder and the recovery of each problem is usually contingent on the recovery from the other problems. In Dr P's case, his ongoing recovery from substance abuse would be enhanced by further improvements his depression and anxiety.

1. Dr Cementon recommend that Dr P continue his treatment with his psychiatrist and his general practitioner, his participation in mutual help groups and his attendance at the VDHP for his substance use disorder. He noted Dr P's engagement with the VDHP had been very low and must be improved because the goal is for Dr P to indefinitely maintain his remission from substance dependence. Long-term participation in substance use mutual help groups would facilitate this.
2. He supported conditions on Dr P's registration imposed by the Board in January 2015. Dr Cementon made the following recommendations:

Dr P does not return to anaesthetic work as this work setting contains factors that could lead to relapse in substance misuse. The return to work in a general practice, medico legal or teaching setting is appropriate.

Dr P works in a group setting where the support and supervision from medical colleagues is available given more than two years have passed since Dr P was in active medical practice.

The restriction to not more than 40 hours of clinical contact a week is appropriate as he has not been in the general practice setting for several years and his return to this work should be graduated.

Random urine drug screening should resume on his return to work as a medical practitioner in order to corroborate his history regarding his abstinence from drug misuse. As his remission from substance dependence now exceeds twelve months, it is not necessary to obtain at least twelve urine screens per month; I would recommend less frequent urine screening and the addition of gas-chromato-mass-spectrometry testing (GCMS) to the urine testing to confirm the nature of the substance in the case of a positive screen.

Hair testing every three months should also take place to provide a longer-term appraisal of Dr P's substance use.

The prohibition on the prescribing or administering of Schedule 8 drugs and propofol and the prohibition on the possession and self-administration of Schedule 8 drugs or Schedule 4 drugs of dependence unless prescribed for him by his treating practitioners should be maintained in order to maintain his current remission from substance dependence.

Dr P should continue to attend his treating psychiatrist and general practitioner and the attendance to an addiction specialist is at the discretion of his treating psychiatrist and GP.

1. Turning to Dr P's evidence and opinion concerning the days on which he agreed that he did not present for testing when he had worked that day, he provided explanations. We summarise them as concerning:

1. 3 July 2012 (Allegation 1), while Dr P had advised the Board he would be taking leave to go to Ireland from 30 June to 31 July 2012, he had to delay his departure (due to the volcanic eruption in Iceland) and was then offered work on 2 and 3 July and in the confusion of having to then collect his wife from Melbourne airport, did not undertake a test; 2. 15 August 2012 (Allegation 2), this was in the context of his father dying on 14 August and in trying to organise flights back to Ireland; he left on 17 and returned on 27 August 2012;

1. 3 September 2012 (Allegation 3), while he had not intended to work that day he was asked to and did so. In the afternoon he had an appointment with a dermatologist who sent him for an x-ray which confirmed a fractured nasal bone, by which time the pathology service for urine testing was closed;

1. 10 September 2012 (Allegation 4), he referred to his 3 September dermatologist appointment and the fact that on 4 September he underwent a surgical procedure. We pause to comment how this explanation relates to him not being tested a week later, when he worked, was not clear; 2. 7 December 2012 (Allegation 5), this is in the context that he was not expecting to work, as he had advised the Board by letter dated 27 November 2012. He was not trying to mislead, he was trying to inform the Board; 3. 3 January 2013 (Allegation 6), while he had advised the Board that intended to be on holiday and his plans changed when he was offered work. He denied any intention to deliberately mislead the Board; 4. 9 January 2013 (Allegation 7), Dr P offered no excuse for not undertaking a test; 5. 7 February 2013 (Allegation 8), following surgery in mid-January to repair a ruptured bicep tendon in his right arm, and a period of convalescence, following working in the morning, on the afternoon of 7 February Dr P saw an orthopaedic surgeon for review of the arm condition. By the time that was finished, the pathology service was closed; 6. 14 March 2013 (Allegation 9), Dr P underwent a prolonged dental treatment in the afternoon and again once that was over the pathology service was closed. Dr P mentioned he was also concerned that the 'strong dose of local anaesthetic' may show up in urinalysis; 7. 25 March 2013 (Allegation 10), that day Dr P experienced acute back spasm, which deteriorated during the day. He managed to complete two sessions with difficulty and immediately went to see his doctor who prescribed analgesic and ordered x-rays. He obtained a medical certificate. Dr P said in the circumstances he understood he was not required to undergo testing. We comment below on Dr P's stated belief concerning the interrelationship between obtaining a medical certificate and the requirement for testing; and 8. 4 Apri1 2013 (Allegation 11), we do not understand why Dr P's excuse relates to 5 April 2013. We have no reason to doubt his evidence that he did not work on 5 April.
2. Related to the above, Dr P maintained that over the times in question he understood that if he worked sessions on a morning and for some reason had to see a medical practitioner in the afternoon, whether or not the practitioner he saw diagnosed him as suffering some malady which would impact on his ability to undertake urine test, he was excused from having to undertake a test that day. Before us, he agreed that in retrospect his stated belief appears foolish.
3. Dr P stridently denied that his relationship with the Board over the times in question had been combative or that he had in any way failed to cooperate with the Board. He provided a sheaf of correspondence from him to the Board related to the times in question. It appears from the correspondence he is either proactively raising issues concerning his work schedule or answering questions from the Board.
4. Dr P was emphatic in his evidence that the 'galling' aspect from his point of view concerning his non-compliance with testing is that over all this time he was drug-free.
5. Concerning being subject to registration conditions and obtaining employment, we accept Dr P's evidence that he finds it very difficult to secure employment. We accept his evidence that commonly the first thing prospective employers do is look up his registration status, and lose interest. We accept he has made about 30 applications resulting in two unsuccessful interviews. This has had a severe adverse effect on, among other things, his family and finances.

1. We find under s196(1) of the National Law that:
   1. With respect to Allegations 1 to 11, 13 and 14 in this proceeding, Dr P behaved in a way which constitutes professional misconduct as defined in paragraph (b) of s 5 of the National Law. The multiple instances of unprofessional conduct that, when considered together, amount to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience.

Our focus was on the multiple instances of Dr P failing to undergo testing. His various explanations had a 'the dog ate my homework' air to them.

While we do not disbelieve his evidence as to the circumstances surrounding various of the dates in question, the reality is that a medical practitioner whose career, and potentially the protection of the public, depends on strict compliance with a strict random testing regime, must not place him or herself in the position where circumstances more than very rarely prevent the practitioner undertaking testing. In this we include circumstances such as the combination of working in the morning and the need to seek medical assistance in the afternoon, creating a risk that the pathology service which offers the testing will be closed by the time the practitioner is able to access it.

Even if Dr P believed that if he obtained a medical certificate before or after working on a day, irrespective of whether the medical certificate related to his ability to do testing or whether or not he was fit to undertake employment that day, he was then excused from attending testing; the belief is so lacking in logic such that it provides no excuse.

Concerning Allegation 13, whether or not Dr P intended it, the reality is that his correspondence to AHPRA and medical certificates he provided did indicate he had not worked on certain dates when in fact he had worked.

1. As Dr P concedes with respect to Allegation 15 in this proceeding in self-administering propofol, Dr P behaved in a way which constitutes professional misconduct as defined in paragraph (a) of s 5 the National Law. His conduct constituted unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience.

1. Section 196(2) of the National Law provide VCAT's powers to make a range of determinations, including caution, reprimand, suspension, requiring further education, imposing conditions on registration, requiring supervision, imposing a fine and cancelling registration.
2. Turning to how the determination powers should be exercised, in Honey v Medical Practitioners Board of Victoria [2007] VCAT 526 at para 14 VCAT said:

It is of prime importance in assessing the appropriate sanction that we bear in mind that the purpose of the determination is not to punish ... Our aim must be to protect the public, and we achieve that aim by imposing sanctions aimed at regulating professional performance of the particular individual under consideration and also by way of general deterrence to the profession as a whole.

1. As the parties submitted was appropriate, we reprimand Dr P for the conduct relevant to our findings.
2. We note Marks J's comments in Peeke v Medical Board of Victoria[3] that a reprimand, being a serious form of censure and condemnation, 'certainly does not trivialise a serious lapse of professional standards, and has the potential for serious adverse implications for the medical practitioner.' [4]

1. With the factual basis for the allegations largely agreed and Dr P accepting the majority of the conditions the Board proposed, this proceeding focused on Dr P's future conditional registration as a medical practitioner The litmus test is what is required to protect the public.
2. We made our determination set out at pages two and four of this decision to achieve specific deterrence, general deterrence and protection of the reputation of the profession.
3. While we accept that the conditions make it very difficult for Dr P to obtain employment as a general practitioner, in our view they are the minimum required to protect the public, which must take precedence over his employment prospects.
4. We now turn to the issues in dispute between the parties concerning the then proposed conditions.
5. Concerning the condition we imposed at 3(a) of our determinations, 'Not to prescribe or administer Schedule 8 drugs.' The Board proposed the sentence end with the words, 'and propofol' as was stated in the January 2015 conditions.
6. Given Dr P submitted naming the drug is a red flag (our words) to potential employers, in the context that they will become aware of the reasons for the conditions we viewed the words as unnecessary given the condition we have imposed that he not practice in anaesthesia, and did not include them.
7. Dr P did not oppose the conditions the Board proposed and we imposed at 3(b), 3(c), 3(d) and 3(e) about determinations.
8. Dr P raised four issues concerning the conditions which became 3(f) of our determinations.
9. First Dr P submitted it was appropriate to modify conditions proposed by the Board such that if Dr P received a job offer, the Board would be required to consider whether or not to approve him undertaking that employment on an expedited basis. In his view, the potential for two to three weeks to pass between him seeking approval, having received a job offer, and the decision being made ruled him out of job offers being made and/or meant that an offer made may be withdrawn.
10. Mr McPherson gave evidence that the two to three weeks for approval related to fortnightly meetings of the Board's relevant subcommittee. He also gave evidence that in his experience that delay had not prevented people obtaining employment. We understand that at some point in the process of considering the circumstances of the employment of a person working subject to conditions, that subcommittee may delegate speedy decision-making to a single member of the subcommittee.
11. We accept the Board submissions that at this point, with respect to Dr P, there is no reason to by way of conditions to attempt to dictate to the Board the timeframes in which it should make its decisions, even if such was possible (which was not a subject of submissions).
12. Second, Dr P requested a broadening of the proposed condition that he was not to undertake 'on-call or after hours work'. While he did not seek to work on call, he made a reasonable point that increasingly in general practice, work on a Saturday afternoon or Sunday is not regarded as after hours.
13. After discussion the Board agreed and we decided it was reasonable to permit him to work for not more than 40 hours of clinical contact per week (another condition which Dr P did not dispute) between 8 am and 8 pm Monday to Sunday, on the condition that he was only to work when there was at least one other medical practitioner on-site (see next issue).
14. Third, Dr P submitted rather than him being prohibited from working unless there was at least one other medical practitioner on-site, the requirement could be for a health practitioner, such as a registered nurse, to be on site. In his experience, a potential employer wanting him to work in a regional area or on a Saturday afternoon or a Sunday would be wishing to only employ one medical practitioner at the time, accompanied by a health practitioner such as a registered nurse.
15. While we saw some logic to his proposal, including that any registered nurse working with Dr P would be well aware of his conditional registration, and would probably closely supervise the availability of drugs, we preferred the Board's submission that what was intended was, meaning no disrespect to the nursing profession, peer to peer supervision and support in the context that Dr P has not had recent substantial clinical experience as a general practitioner.
16. Fourth, we agreed with Dr P's submission that a condition that he provide a monthly statutory declaration to AHPRA, declaring that it complied with the conditions on his registration, was not required.

1. In the context of rigourous random drug testing and the other conditions imposed, a doctor declaring compliance where the doctor was compliant would add little. A doctor who was prepared to lie would do so. The outcome, for a doctor who lied and was later found to have breached conditions, in Dr P circumstances, would not likely be different given swearing of multiple statutory declarations.
2. Our blunt observations in the above paragraph are theoretical and have no relevance to Dr P's honesty or credibility.
3. At Mr Collopy's suggestion, with which neither party took issue, we amended the proposed condition that Dr P not work 'in the areas of anaesthesia and sedation' to read:

Not to work in the areas of general and regional anaesthesia (excluding standard local anaesthesia) and sedation for procedures.

1. This addresses the risk of Dr P being unnecessarily hampered in general practice as he treats patients.

1. Finally, s 196(3) of the National Law requires VCAT to set a review period for conditions. The Board proposed a year. Dr P proposed six months.
2. We have set a one year review period after Dr P gains employment as a general practitioner. We very much doubt a review after six months would result in the Board changing the conditions, given that at that time there would be insufficient evidence to assess likely ongoing success or failure.
3. Dr P should note that such reviews are conducted when after the required time passes, the practitioner in question may request a review. We understand the Board will not contact him after a year to initiate a review.

[1] As set out in the schedule to the Health Practitioner Regulation National Law Act 2009 (Qld) adopted in Victoria under the Health Practitioner Regulation National Law (Victoria) Act 2009.

[2] Under s 146 of the Victorian Civil and Administrative Tribunal Act 1998.

[3] Unreported, Supreme Court of Victoria, No 10170 of 1993, 19 January 1993, at page 6.

[4] As quoted in Medical Practitioners Board of Victoria v Swieca (Occupational and Business Regulation) [2009] VCAT 419 at [52].