Medical Board of Australia v ZQX

(a) Whether allegation eight should include findings beyond Person A;

(b) Depending on the answer to (a), whether the Tribunal should make a separate finding that the respondent's admitted conduct is professional misconduct or unprofessional conduct;

(c) Whether the respondent's admitted conduct in respect of each of allegations seven and nine supports findings of unprofessional conduct;

(d) Whether the appropriate final order is a reprimand, as proposed by the Board or no further sanction as proposed by the respondent.

• [6] The respondent was, at all relevant times, a general practitioner working in regional Queensland. He obtained his university qualifications in medicine in 2000 and was first registered in Australia under the predecessor regime to the National Law on 3 September 2007. He has fellowships with the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine.
• [7] He has no disciplinary history.
• [8] He has a long history of mental health issues which are relevant to the proceeding.
• [9] The respondent made substantial admissions to the gravamen of the conduct the subject of the allegations in the referral in a submission dated 12 February 2021 sent on his behalf shortly after he got a letter dated 27 January 2021 advising him the notifications had been made. This was more than three years prior to the referral being filed in the Tribunal.
• [10] Although he worked between August 2020 and June 2021 without any incident related to prescribing to Person A[2], on 28 June 2021 the Board determined to wholly suspend his registration consequent upon the issues giving rise to this referral. The suspension was in place until 23 May 2023, at which time the Board determined to revoke the suspension and impose conditions prohibiting the respondent from prescribing any schedule 8 medication and any drug of dependence. On 19 June 2023, the respondent applied to the Tribunal to review the decision to revoke the suspension and impose the conditions and on 1 November 2023 the Tribunal made an order inviting the board to reconsider the decision of 23 May 2023. The Board did so and determined to confirm its decision and impose a new condition on the respondent's registration requiring that, before he returned to practice, he obtain a report from his treating psychiatrist stating that he is fit to do so (Immediate Action Decision).
• [11] On 31 May 2024 the Tribunal, differently constituted from today, set aside the Immediate Action Decision. The respondent remains subject to health conditions imposed by the Board on 8 December 2020 requiring he undertake treatment with a psychiatrist or psychologist at a frequency determined by the treating practitioner but at a minimum of every three months (Health Conditions).
• [12] Since mid 2024, the respondent has been working in a regional hospital in another state. His current supervisor has provided an affidavit setting out that he has full knowledge of these proceedings and that he is strongly supportive of the respondent as a worthy employee, a safe clinician and a good team member. He deposes that the respondent has followed every direction he has been given, has not been the subject of any complaint, and has been exemplary in his transparency with his employer.

• [13] The parties agree by way of the respondent's admissions that:

(a) He prescribed medications to Person A between 11 August 2019 and about 3 July 2020[3]. That involved a total of 86 prescriptions[4] and included prescribing paracetamol + codeine on 51 occasions and tramadol on 17 occasions[5];

(b) Apart from the first occasion on which he prescribed paracetamol + codeine and tramadol, he did not undertake an adequate clinical assessment of Person A prior to giving each of those prescriptions;

(c) He failed to make any clinical record of any assessment undertaken with respect to the other medications he prescribed to Person A;

(d) He did not provide appropriate follow up care to Person A in respect of her ongoing use of, and need for, paracetamol + codeine and tramadol and he prescribed those drugs in (cumulatively) large quantities that were not appropriate in the circumstances;

(e) On about 14 October 2019 he treated Person A when she presented at the hospital where they both worked, by administering 5ml of a solution of Betamethasone 6mg in 20ml;

(f) This conduct constitutes professional misconduct.

• [14] The parties agree by way of the respondent's admissions that:

(a) Person A and the respondent met in about June 2019 at the hospital where both of them worked. Person A was employed as an acute care clinician;

(b) In or around June 2019 Person A and the respondent developed an intimate and personal relationship;

(c) In about August 2019 Person A and the respondent met outside work in a social context and she asked that he prescribe her pain relief for her rib;

(d) On about 11 August 2019 the respondent prescribed Panadeine Forte at a quantity of 20 tablets with no repeats for Patient A;

(e) On about 14 October 2019 the respondent treated Person A at the hospital where they both worked, by administering 5ml of a solution of Betamethasone 6mg in 20ml 1%) and he administered a second injection five to seven days later at her house;

(f) From about November 2019 Person A and the respondent cohabited on and off, then, from January 2020 they cohabited on a consistent basis;

(g) In early July 2020 Person A and the respondent moved towns as a family unit;

(h) Their relationship ended late 2020;

(i) The respondent failed to maintain appropriate professional boundaries with Person A to the extent that he regularly provided Person A with medications whilst in an intimate and personal relationship with her;

(j) This conduct constitutes professional misconduct.

• [15] The parties agree by way of the respondent's admissions that in the period from around August 2019 to 3 July 2020 the respondent failed to maintain clinically adequate records for Person A evidencing his prescribing of medications as set out in ground one and that this constitutes professional misconduct.

• [16] The parties agree by way of the respondent's admissions that on about 28 November 2019 the respondent wrote a prescription to Person B for tadalafil and ondansetron in circumstances where he had a close personal relationship with Person B at the time and Person B was not a patient of the respondent. Further, Person B was not a patient of the hospital where the respondent worked but the respondent used the hospital's prescription pad. The respondent did not make any adequate records indicating he had undertaken any assessment, history taking, or a clinical justification for prescribing the medication. This conduct constituted unprofessional conduct.
• [17] Whilst it is not an agreed fact, it is not disputed that Person B was Person A's child. It is unknown how old Person B is.
• [18] There is no evidence that this prescription was ever dispensed.

• [19] The parties agree by way of the respondent's admissions that on about 28 May 2020 he wrote a prescription for Person E for Panadeine forte and diazepam. Person E was a friend of Person A, the respondent's partner at the time and was not a patient of the hospital or of the respondent at the time he wrote the prescription. The respondent used a hospital prescription pad and he failed to make any adequate clinical notes to record the prescription.
• [20] The parties agree that this conduct constitutes unprofessional conduct.

• [21] The parties agree by way of the respondent's admissions that on about 24 April 2020, he wrote a prescription to Person C for diazepam and levonorgestrel. Person C was a friend of Person A's at the time such that he should not have written the prescription and he used a hospital prescription pad to write the prescription when Person C was not a patient at the hospital. The respondent failed to maintain any adequate clinical records for the prescription. The parties agree this conduct amounts to unprofessional conduct.

• [22] The parties agree by way of the respondent's admissions that on about 29 March 2020 he wrote a prescription for Person D for Cortival cream, Person D was the child of Person A and he did not make any clinical record for the prescription.

• [23] The parties agree by way of the respondent's admissions that:

(a) he made out prescriptions for Person A using prescription pads from two hospitals and for each of Persons B, C, D and E he used a prescription pad from a hospital when none of the patients were patients of the hospital;

(b) in the period from 13 June 2019 to 3 July 2020 as reflected by the actions in sub-paragraph (a), the respondent failed to use and store prescription pads in accordance with proper practice.

• [24] The respondent admits that a temporary protection order varied order (TPO) was made on 4 February 2021 which included that the respondent was prohibited from contacting or attempting to contact or asking someone else to contact Person A. On 7 March 2021 he breached the TPO by contacting Person A and he pleaded guilty to one charge of contravening a domestic violence order for which he was fined $800 with no conviction recorded.
• [25] The contact which constituted the breach were two text messages the respondent sent Person A, one of which was about dropping Person A's dog off to her complex as he had found the dog in the street and the second of which, was in response to Person A sending a message acknowledging the first text message of the respondent.

How should the Tribunal characterise the practitioner's conduct ?

• [26] The respondent accepts that his conduct giving rise to each of grounds one, two and three may be characterised as professional misconduct and that the conduct in each of grounds four, five and six (of 'one off prescribing') amounts to unprofessional conduct. The Board accepts this characterisation is consistent with authority[6].

• [27] Whether this constitutes unprofessional conduct is disputed by the parties.
• [28] The respondent says he wrote the prescription to treat Person D's eczema in circumstances where it had previously been prescribed to Person D by another medical practitioner in the town, with whom Person D was unable to get an appointment for around six weeks, and in those circumstances writing the prescription was appropriate.
• [29] The Board maintains that writing the prescription for Person D was improper because of the relationship between Person A and the respondent at the time of the prescribing, the role the respondent had in Person D's life at the time (in that the respondent, Person A and her children were living together) and because he failed to keep any records of his prescribing but submitted that professional assessors should inform the Tribunal whether:

(a) The treatment of eczema is unavoidable or cannot be delayed; and/or

(b) A request could have been made for Person D's usual medical practitioner to issue a repeat prescription for Cortival cream pending an appointment; and/or

(c) Other treatments for eczema are available over the counter at a pharmacy such that the circumstances of Person D suffering from eczema do not justify prescribing for someone the Respondent was in a close relationship with.

• [30] The professional assessors have provided the opinion that the course which the respondent adopted here was entirely unremarkable, that this is the type of situation which comes within the exception to the Code of Conduct, particularly in the circumstances of this being a regional area and the uncontested evidence is that Person D was a toddler who had an obvious condition which was very distressing and there was not the ability to get an appointment for about six weeks[7].
• [31] The Tribunal determines in relation to ground seven that the respondent has no case to answer and no further action is to be taken in relation to the matter.

• [32] The respondent admits that he made prescriptions for Person A using prescription pads from two different hospitals and for Persons B, C and E that he used a prescription pad from one hospital. He also admits that proper professional practice requires that the prescription pads be used only for patients of the hospitals in the circumstances.
• [33] Whilst initially submitting in writing that in respect of Persons B, C and E this allegation is duplicitous of the matters alleged in grounds four, five and six and accordingly there should not be any separate finding of unprofessional conduct or professional misconduct in relation to ground eight, the respondent accepted in oral argument that as the particular of each of grounds four, five and six about the use of the hospital's prescription pads was unnecessary for a finding to be made on those allegations, he would no longer press his argument in relation to this ground. That concession was appropriate.
• [34] The first point, however, is that they are separate grounds alleged. Duplicity arises when more than one offence is joined in one count[8]. That is not what has occurred here.
• [35] Additionally, in two respects this ground goes beyond the alleged particulars of the other grounds.
• [36] The first is that the particulars for Count 8 allege that there was a guideline concerning the use of prescription pads which the respondent was or ought reasonably to have been aware of which required that they were issued to wards for use there to minimise the risks associated with the misappropriation of them. The respondent admits proper professional practice requires that the prescription pads be used only for patients of the hospital. This is a different concern from that in each of grounds four to six.
• [37] The second is that there is no equivalent particular alleged or admitted in relation to Person A, in ground one which is the ground related to prescribing to her. The bulk of the prescribing in fact was to Person A.
• [38] Ground eight is not duplicitous of grounds four, five and six.
• [39] In deciding whether the respondent's conduct should be characterised as 'professional misconduct' or 'unprofessional conduct', the Tribunal is required to make a judgment as to the degree of departure from the standard reasonably expected of the respondent by the public and/or his professional peers.[9]
• [40] In this case, given the findings which have already been made concerning grounds one, four, five and six, the additional aspect of not complying with professional practices relating to the use of hospital prescription pads is properly considered to be unprofessional conduct.

• [41] The dispute between the parties arises because the respondent denies this conduct constitutes unprofessional conduct or professional misconduct.
• [42] The Board contends that whilst the breach is at the lower end of the scale of potential breaches of a DVO, a breach of a DVO is contrary to what the community and the respondent's professional peers expect of him[10]. Given the absence of threats or coercion evident in the context of the text messages the respondent sent Person A, the Board seeks a finding of unprofessional conduct[11].
• [43] Unprofessional conduct of a registered health practitioner is defined in the National Law as professional conduct that is of a lesser standard than that which might reasonably be expected of the health practitioner by the public or the practitioner's professional peers and includes, relevantly, the conviction of the practitioner for an offence under another Act, the nature of which may affect the practitioner's suitability to continue to practice the profession.
• [44] The respondent contends that the contravention should be regarded as at the lowest end, involving two text messages which did not contain threats or abusive language, particularly where it is said that Person A was baiting the respondent.
• [45] This Tribunal has recognised that there can be "light and shade" to conduct constituting offences which are family violence offences, including factors which reinforce the conduct is out of character and serves as a distinction from conduct (and offences) in other cases where the particular circumstances were not present[12]. The Tribunal has also accepted that as a general proposition misconduct in the course of performing professional duties, particularly by the commission of criminal offences, is regarded more seriously in disciplinary proceedings than misconduct committed outside those duties.[13]
• [46] Each case will turn on its particular facts.
• [47] The conduct giving rise to the contravention of a DVO was particularly low level and was unrelated to the practice of his profession or the workplace. It involved two text messages, the first of which was to tell Person A he had dropped her dog off to her complex because he had found it on the street. The second text message was in response to one from Person A acknowledging his message. It dealt with more personal matters in that it alluded indirectly to the relationship he and Person A had had but is properly characterised as not threatening. It was sent at a time when the respondent was on medical leave, having suffered some sort of episode for which he had been hospitalised only several weeks before[14] and his treating psychiatrist had assessed his mood as labile[15]. Notwithstanding that the respondent was charged with numerous additional alleged breaches, all were discontinued and he was discharged. Thus, the event is an isolated one, which appears to be out of character.
• [48] Additionally, as events between the respondent and Person A played out, by early 2022, the QPS had concluded relevantly that they had sighted a pattern of behaviour from Person A of contacting the respondent and subsequently reporting the respondent for breaches of a separate domestic violence order and that the repetitive nature of the actions of Person A had shown a pattern of coercive control over the respondent perpetrated by Person A[16]. Ultimately, it is Person A who is facing charges arising from her actions towards the respondent.
• [49] The Tribunal notes the Board's submissions at paragraphs 170 to 185 and its submission in oral argument that it seeks a finding based on the policy position that medical practitioners should obey the law. The Tribunal has given them careful consideration. Any contravention of a DVO is to be deprecated and drawing a conclusion that a contravention of a domestic violence order gives rise to no disciplinary outcome is likely to be extremely rare. However, in the circumstances of this case, the Tribunal is not satisfied that the respondent's plea of guilty to the single contravention of a domestic violence order constituted by sending two text messages, the first of which was anodyne, is one which may affect his suitability to continue to practice the profession, or is otherwise unprofessional conduct or professional misconduct.
• [50] The Tribunal determines in relation to ground nine that the respondent has no case to answer and no further action is to be taken in relation to the matter.

What does the Tribunal conclude on the characterisation question ?

• [51] The respondent submits there should be a global finding of professional misconduct for the grounds which have been made out,
• [52] The Board accepts that the Tribunal could make a global finding of professional misconduct pursuant to subparagraph (b) of the definition of that term in the National Law.
• [53] The Tribunal is of the view that the appropriate approach to characterisation is to make a single global finding of professional misconduct pursuant to subparagraph (b) of the definition of that term in the National Law. This is because the thread which runs through all the grounds involves the respondent's actions in the context of his then current relationship with Person A: his prescribing to her whilst in a relationship with her, his prescribing on a one off basis to her children and friends whilst in that relationship, his failure to keep relevant notes concerning that prescribing and his failure to follow proper practices concerning prescription pads. This is against a backdrop of the respondent being a person with established mental illness, for which he had been seeking treatment for some years.

• [54] The purpose of a sanction is to protect the public; it is not to punish the practitioner (although a practitioner may experience a protective action as a punishment, in the sense of negative consequences towards them). The Tribunal's disciplinary jurisdiction is exercised for the paramount purpose of protecting the health and safety of the public[17] and the protection of the reputation of the profession in the public mind.
• [55] There are well established considerations for the Tribunal on a disciplinary referral[18]:

(a) preventing practitioners who are unfit to practice from practicing;

(b) bringing home to the practitioner the seriousness of their conduct;

(c) deterring the practitioner from future departure from appropriate standards or others who might be minded to act in a similar way; and

(d) imposing restrictions on the practitioner's right to practice to ensure public protection.

• [56] An assessment of ongoing risk posed by the practitioner is essential to any determination of sanction. In performing that assessment, the degree to which the practitioner has acquired insight will be relevant.[19]
• [57] Having decided that the practitioner has behaved in a way that constitutes (or includes) professional misconduct, the Tribunal has a wide discretion to impose sanctions ranging from a caution or a reprimand of the practitioner to the cancellation of registration.[20]
• [58] The Tribunal will consider a range of factors in a given case including the nature and seriousness of the alleged conduct, the extent to which the practitioner has shown contrition, insight or remorse for their conduct, the need for general or specific deterrence, evidence of rehabilitation and otherwise good character, including co-operation with the disciplinary process and the regulator and any mitigating factors which are personal to the practitioner.
• [59] The gravity of professional misconduct is not to be measured by reference to the worst cases, but by the extent to which it departs from the proper standards.[21] The parties have advanced a number of cases in written submissions.
• [60] The Board seeks a reprimand, submitting that a reprimand will achieve the objects of the disciplinary proceeding by deterring other practitioners from similar conduct, denouncing transgressions and articulating the high standards expected of the profession. It points to the fact that a reprimand is required to be recorded on the public register as contributing to achieving general deterrence. In oral argument the Board informed the Tribunal that the position now is that there is no policy of a reprimand remaining on the register for five years; rather that after two years an application can be made for removal.
• [61] In reaching a decision on sanction, the Board submits the Tribunal should consider:

(a) The respondent's admissions which have enabled this matter to proceed efficiently;

(b) The period of time during which the respondent's registration was suspended, which was a period of nearly two years;

(c) The absence of any further notifications relating to the respondent's personal conduct or his performance of the profession, since these allegations, which relate to conduct now five years ago;

(d) The respondent's ongoing compliance with the Health Conditions the Board imposed in December 2020;

(e) The respondent's current stable employment since July 2024;

(f) The education completed by the respondent in response to the notification; and

(g) The character reference of his current supervisor, provided by way of affidavit.

• [62] In respect of the suspension, the Tribunal notes the respondent's unchallenged evidence that the conditions the Board imposed when it lifted the suspension rendered the respondent essentially unemployable and it was not until the Tribunal set those conditions aside about twelve months later that the respondent was able to obtain work as a medical practitioner. There was therefore, a total period of approximately three years where the respondent could not work as a medical practitioner. The respondent has deposed to the significant financial loss he has suffered through being suspended without pay and not working.
• [63] The respondent has deposed to changing his practices and to having no ongoing association with Person A or any of the other persons the subject of grounds in the referral. His treating psychiatrist has reported that as at August 2024, his symptoms were in remission and his current treating psychologist has opined that the respondent did not require further treatment[22].
• [64] The Tribunal also notes the respondent has no other disciplinary history, he had ceased prescribing to Person A voluntarily, before he was notified of the Board's concerns and he had facilitated a referral to another general practitioner concerning Person A's use of narcotics. His admissions in early 2021 were extremely prompt upon being notified in early 2021 of the Board having received a notification. Whilst he was at work between 4 July 2020 and 28 June 2021, he did not further prescribe to Person A or those associated with her, he implemented changes to his practice, he did not engage in any other alleged inappropriate prescribing and he maintained appropriate professional boundaries in the workplace. The respondent submits his insight is high, given the evidence from his new employer as to his transparency with them. There has been, too, a long delay between his initial admissions and the final determination of this referral.
• [65] The respondent accepts that his conduct is serious and submits that if the proceeding had been completed timeously, and if he had not already been suspended, a reprimand would have been required, perhaps with some period of suspension[23].
• [66] The respondent submits that given the features in this case, and the fact that personal deterrence is not a relevant consideration, a reprimand is not required and further the case is not a relevant vehicle for general deterrence because of his mental health issues. In making that submission, the respondent accepts that there is no evidence that his mental health issues contributed to the actions which bring him here today. He submits that it has relevance because there is evidence that the protracted regulatory action has been the dominant factor in his depression as at December 2023 and because of the risks to his mental health if any sanction has a negative effect on his employment. There is evidence from his current treating psychiatrist for the former and evidence from himself in respect of the latter.
• [67] At the oral hearing the respondent tendered a treating practitioner report made to Ahpra dated 14 October 2025 in which the respondent's treating psychiatrist expressed the opinion that the respondent's mental health condition is in remission, he continues on a regime of medication, and the treating practitioner expresses the opinion that the Health Conditions requiring attending at a treating practitioner can be removed, where the respondent has good insight into managing his Bipolar Disorder Type 2 and the practitioner is confident he can appropriately self manage his condition and frequency of appointments.
• [68] The respondent referred the Tribunal to the decisions of R v Tsiaris[24] and Health Ombudsman v NMS[25]. The Tribunal has carefully considered these authorities which the respondent advances for points of principle relating to the role of mental health conditions in devising of appropriate punishment, not as comparable cases. It is worth noting that in NMS there was an express finding at [26] that it was more likely than not that the conduct would not have occurred, but for the mental health issues and that there was evidence that there was a direct causal link between theses issues and the respondent's conduct; this case does not support the general position contended for by the respondent. The Tribunal has also had reference to the decision in R v Yarwood[26] where White J explained the effect of Tsiaris as:

"...Tsiaris, Verdins and Goodger and many other decisions recognise that a sentence which involves imprisonment actually to be served may often weigh more heavily on an offender suffering from psychiatric ill health just as an offender who suffers from physical deficits will experience more difficulty in prison than a person of normal robust health. It is usual for a sentencing court to moderate a sentence to balance this factor ..." and further at [33] "... that a prisoner suffering from serious psychiatric illness is not an appropriate vehicle for general deterrence..."

• [69] On the current evidence, the respondent's mental health condition is in remission. There is no evidence he was suffering from a mental health condition at the time of the conduct comprised of grounds one to eight.
• [70] In response to the view of the professional assessors put to the respondent that a reprimand would need to be disclosed to the employer but would not operate as a limitation on work, the respondent made submissions on instructions that a reprimand would need to be disclosed to his employer, and this would trigger a review of his credentialling, but the outcome of this was unknown.
• [71] In the event that the Tribunal determines it is appropriate to impose a reprimand, the respondent submits that the Tribunal should express a recommendation that it be removed in a short period, suggesting six months.
• [72] The professional assessors expressed the opinion that a reprimand was necessary because of the seriousness of the conduct in ground one, the prescribing to Person A. This is because, on their assessment of the frequency of the prescribing of paracetamol and codeine, that the respondent ought, at the very least, to have been well aware that Person A was at risk of harm. This is because the volumes of paracetamol +_codeine being prescribed at the frequency they were being prescribed, exposed Person A to severe and potentially fatal liver damage. The respondent's submission in response to this is that there is no evidence of inappropriate prescribing absent the tumultuous relationship in which the respondent found himself with Person A. The Tribunal does not accept this submission in the context that there can be no control over who the respondent chooses to enter into a relationship with or the terms of that relationship.
• [73] Based on the opinion of the professional assessors, the Tribunal is also concerned about the report of his then treating psychiatrist from March 2021. His treating psychiatrist between 2016 and 2020, Dr Trott, opined in a report dated 3 March 2021 that:

(a) In August 2020, when he saw the respondent, the respondent had reasonable insight into his condition and the respondent's judgment was socially competent. At that time the respondent presented as feeling somewhat overwhelmed, with lowering of mood, problematic sleep and lessening in his energy and concentration levels;

(b) The respondent is aware of the adverse impact of work stress and other stressors in destabilising his mood;

(c) The respondent recognises the benefits of mood stabilisers;

(d) The respondent would benefit from regular psychological therapies in managing his Bipolar Disorder Type II as well as continuing on mood stabilisers; and

(e) The respondent is to be wary of increased work demands.

• [74] It was apparent from that report that the respondent had not attended his treating psychiatrist for almost a year at that time, and that during that time he had been altering his medications and had attempted to manage 'as is' rather than actively engaging in treatment.
• [75] Accepting that the Tribunal has to make its decision now, on the basis of the information presently before it, the guiding principle of the National Law is the protection of the public. Accepting the opinions and concerns of the professional assessors, the Tribunal determines that it is appropriate to impose a reprimand to mark the seriousness of the conduct. In doing so, the Tribunal recognises that a reprimand is not a trivial penalty.[27]
• [76] The Tribunal takes the view that this is not the case in which to express any opinion about the recommended duration of the reprimand.
• [77] The Tribunal has derived assistance from the assessors on questions of fact and thanks the assessors for their thoughtful engagement and assistance

• [78] The Tribunal makes the following orders:

1. Pursuant to section 196(1)(b)(iii) of the Health Practitioner Regulation National Law (Queensland) ('National Law') in respect of grounds one, two, three, four, five, six and eight, the respondent has behaved in a way that constitutes professional misconduct.
2. Pursuant to section 196(1)(a) of the National Law the respondent has no case to answer in respect of ground seven and ground nine in the referral.
3. Pursuant to section 196(2)(a) of the National Law, the respondent is reprimanded.
4. Each party bears its own costs of the proceedings.

[1] Board's submissions Hearing Brief (HB) 296 [11]; respondent's submissions HB 337 [11].

[2] The respondent had some time off on sick leave and completed a return to work plan on 30 March 2021 HB 249 [48].

[3] Agreed schedule of prescriptions HB 235-238.

[4] Board's submissions HB 310 [150](g)

[5] Totalling 1,040 tablets of paracetamol + codeine over 330 days between 12 August 2019 and 7 July 2020; 340 tablets of tramadol over 219 days between 8 September 2019 and 14 April 2020: Board's submissions HB 310 [151].

[7] Respondent's affidavit HB 143 [91].

[9] Health Ombudsman v Niem Quoc Tang [2020] QCAT 165 [17].

[10] Board's submissions HB 313 [175].

[11] Board's submissions HB 314 [183] - [184].

[12] Nursing and Midwifery Board of Australia v LYS [2024] QCAT 209 [87].

[13] Health Ombudsman v JTM [2020] QCAT 394 [21].

[14] Respondent's affidavit HB 133 [19] - [20].

[16] Respondent's submissions HB 133 [19].

[18] Craig v South Australia [2001] SASC 169; (2001) 79 SASR 545, 553- 555.

[19] Nursing and Midwifery Board of Australia v Lockie [2022] QCAT 391 (Lockie) [71] citing Medical Board of Australia v Bromeley [2018] QCAT 163 [142].

[20] Nursing and Midwifery Board of Australia v Lockie [2023] QCA 96 [45].

[21] Health Care Complaints Commission v Litchfield [1997] NSWSC 297; (1997) 41 NSWLR 630 [638].

[23] Respondent's submissions at [27].

[24] [1996] VicRp 26; [1996] 1 VR 398.

[25] [2025] QCAT 240 [23].

[26] [2011] QCA 367 [32].

[27] Psychology Board of Australia v Cameron [2015] QCAT 227 [25].