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[2023] VCAT 603
Victorian Civil and Administrative Tribunal
2023-09-15
Original judgment source is linked above.
Review and Regulation List - medical practitioner - professional misconduct under paragraph (c) of definition in s 5 of the National Law (the Health Practitioner Regulation National Law Act 2009 (Qld) as applied by s 4 of the Health Practitioner Regulation National Law (Victoria) Act 2009 (Vic)) - determination - s 196 of the National Law
Medical Board of Australia v Hmood (Review and Regulation) [2023] VCAT 603
conduct of the practitioner, whether occurring in connection with the practice of the health practitioner's profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession.
(a) protection against further misconduct by the practitioner, by regulating their performance (specific deterrence);
(b) facilitating rehabilitation of the practitioner;
(c) preventing persons who are unfit to practice from practicing as medical practitioners;
(d) general deterrence of other practitioners from similar conduct
(e) maintaining proper ethical and professional standards, primarily for the protection of the public, but also for the protection of the profession; and
(f) maintaining public confidence in the profession, including an appropriate acknowledgement and condemnation of misconduct.
The major difference between a period of suspension and cancellation is that once the doctor's registration is cancelled, he must reapply after the period specified. He is not guaranteed that he will be so re-registered. He must still satisfy the Board that registration is appropriate and that he fulfils the qualifications for general registration ...
Cancellation of registration sends a clear message of unsuitability to practice. Suspension may be thought to indicate confidence in the doctor's future ability to practice once the period of suspension is served.
There are some cases in which it is abundantly clear that deregistration is the only option available to protect the public from a miscreant doctor.
This is apparent in situations in which the practitioner does not accept the inappropriateness of his conduct, or has been shown to be a serial offender.
(a) Board of Australia v Salter [2022] VCAT 1238. A registered medical practitioner was given a 10 year disqualification period, for conduct which included inappropriate prescribing of Schedule 4 and Schedule 8 poisons, and inadequate medical treatment and assessment. The medical practitioner issued prescriptions that were not clinically justified, failed to provide safe and effective care, and did not maintain adequate records. It was found that the medical practitioner also engaged in personal relationships with patients, that he provided ice to a highly vulnerable patient, and purchased ice and GHB from another. The medical practitioner treated patients with whom he had engaged in sexualised conduct. He also falsified medical certificates, and provided false and misleading information to the Board, communicated inappropriately, and breached patient confidentiality.
(b) Medical Board of Australia v Datta (No 2) [2022] VCAT 845. A registered medical practitioner was given a 4 year disqualification period for conduct which included the examination of the chest and genitals of two patients. The medical practitioner engaged in conduct which was sexualised and/ or inappropriate, which was not clinically justified, and failed to obtain informed consent when conducting examinations. He used inappropriate and sexualised language towards patients. The medical practitioner's conduct demonstrated a complete inability to self-regulate his behaviour, which he continued to deny and justify. His actions warranted a serious sanction as the Tribunal had no confidence that the medical practitioner had any remorse or would take time to reflect on how his behaviour may have impacted the patients. The practitioner appears to have spent about eight years out of practice before the findings were made.
(c) Medical Board of Australia v Panda [2019] WASAT 104. A registered medical practitioner was given a 10 year disqualification period for conduct which included examining the chest and genitals of five patients in ways that were neither warranted nor legitimate for the condition or symptoms each patient presented with. The examinations involved the medical practitioner touching the skin of the intimate parts of the patients' bodies with un-gloved hands. In regard to three of the patients, the medical practitioner had also breached a condition which prohibited him from conducting the physical examination of female patients in the absence of a chaperone. The offences occurred in the medical practitioner's consultation room where the patients were alone with him, and he was in a position of trust. The medical practitioner had previously been convicted of unlawful and indecent assault as a result of touching the breasts and/ or vagina of four patients, and kissing the face of another patient, for which he was sentenced to a period of one year imprisonment.
(d) Chinese Medical Board of Australia v Zhao [2020] SACAT 23. A chinese medicine practitioner was given a 15 year disqualification period, and a 15 year prohibition order, for conduct that included digital penetration of a patient's vagina during a massage at his clinic. (He was also found guilty of rape in criminal proceedings and punished to a term of imprisonment.)
(e) Medical Board of Australia v Athinodorou [2020] SACAT 31. A registered medical practitioner was given a 13 year disqualification period, for conduct including sexual misconduct involving 10 patients, over 16 years. He was also prohibited from providing any health service involving any form of physical contact with female patients that included any intimate examination or spinal manipulation which would require them to undress either partially or fully.
(f) Medical Board of Australia v Moschou [2021] SACAT 30. A registered medical practitioner was disqualified, and had his registration permanently cancelled, as well as being permanently prohibited from providing any health service as a result of performing an internal examination of a patient's vagina, without informed consent.
(g) Medical Board of Australia v Parhar [2021] VCAT 1295. A consultant physician at the Bacchus Marsh Hospital was given a 12 year disqualification period, for conduct which included nine allegations of professional misconduct concerning perinatal mortality, which spanned a seven year period.
(a) Medical Board of Australia v Lee [2020] VCAT 568. A registered medical practitioner was given a 6 year disqualification period. He was found to have engaged in professional misconduct with two patients. There were four allegations of him stroking, massaging, or masturbating a patient's penis, with no clinical justification.
(b) Chiropractic Board of Australia v Ebtash [2020] WASAT 86. A registered health practitioner was given a 4 ½ year disqualification period, for professional misconduct, which was clinically inappropriate and of a sexual nature. This conduct included the medical practitioner touching the breasts and/or genitals of five patients through their clothing. In one case, the medical practitioner leant a patient back into his body so that the front of his pelvis and groin were pressing against her buttocks.
(c) Medical Board of Australia v Cukier [2017] VCAT 109. A registered health practitioner was given a 1 ½ year disqualification period. He was found to have engaged in professional misconduct in relation to two female patients. The conduct involved inappropriate physical contact of a sexual nature. In the case of one patient, the conduct was repeated despite the patient's request for it to stop. He also prescribed controlled medications without the necessary permit. The practitioner admitted to the allegations made against him at the Tribunal hearing.
(d) Health Ombudsman v Harirchian [2022] QCAT 143. A registered medical practitioner was given a 2 year disqualification period. The relevant conduct included three allegations involving inappropriate sexual touching of a patient's labia and/ or clitoris, during a consultation which involved the patient discussing symptoms of diarrhoea and the fact she felt unwell. In a separate criminal proceeding, the practitioner was found guilty of sexual assault of a patient during a consultation, and sentenced to 8 months imprisonment. He also pleaded guilty to various dishonesty and drug related offences, resulting in a fine and conviction. His registration had been suspended for two years and nine months before the Tribunal hearing.
(4) If the tribunal decides to cancel a person's registration under this Law or the person does not hold registration under this Law, the tribunal may also decide to -
(a) disqualify the person from applying for registration as a registered health practitioner for a specified period; or
(b) prohibit the person, either permanently or for a stated period, from doing either or both of the following -
(i) providing any health service or a specified health service;
(ii) using any title or a specified title; or
(c) impose restrictions, either permanently or for a stated period, on the provision of any health service or a specified health service by the person.
health service includes the following services, whether provided as public or private services -
(a) services provided by registered health practitioners;
(b) hospital services;
(c) mental health services;
(d) pharmaceutical services;
(e) ambulance services;
(f) community health services;
(g) health education services;
(h) welfare services necessary to implement any services referred to in paragraphs (a) to (g);
(i) services provided by dietitians, masseurs, naturopaths, social workers, speech pathologists, audiologists or audiometrists;
(j) pathology services.
[1] See Medical Practitioners Board of Australia v D (Occupational and Business Regulation) [2010] VCAT 52 at [18]-[19].
[2] See for example: Hmood Judgment 1 at [34]-[47].
[3] Richardson v Oracle Corporation Australia [2014] FCAFC 82 at [118].
[4] Psychology Board of Australia v Asher (Costs)(Review and Regulation)(Corrected**)** [2020] VCAT 1281.
Medical Board of Australia
Hmood
(1997) 41 NSWLR 630